Preloaded injector for intraocular lens implantation without the use of ophthalmic viscosurgical devices

PURPOSE: To evaluate a new preloaded intraocular lens (IOL) injector (KS-VF) that uses ordinary irrigating solution alone to implant a foldable IOL and form and maintain the anterior chamber and capsular bag formation and maintenance. SETTING: Department of Ophthalmology, Kitasato University, School of Medicine, Kanagawa, Japan. METHODS: The KS-VF disposable injector is preloaded with a 3-piece silicone IOL, which is ejected after the injector is filled with ordinary irrigating solution via an irrigation/aspiration tube connected to the injector body. The space created by the irrigating solution in the anterior chamber and the capsular bag was compared with that created by conventional preloaded injectors filled with an ophthalmic viscosurgical device in a post-phacoemulsification porcine eye. Intraocular lens ejection speed and resistance with the KS-VF injector and with the conventional preloaded injectors were also measured and compared. In addition, intraocular pressure was measured in the porcine eye and in 11 eyes of 11 patients. RESULTS: In vitro examination revealed no significant difference in the IOL ejection mechanism between the KS-VF and conventional preloaded injectors. The use of irrigating solution was not inferior to that of OVD and provided sufficient space in the anterior chamber and capsular bag. In clinical use, IOLs were successfully implanted without incident into the capsular bag formed with the irrigating solution. CONCLUSIONS: The KS-VF implants a foldable IOL with irrigating solution alone and requires no intraocular injection or removal of OVD. Possible advantages include improvements in surgical efficiency, avoidance of postoperative IOP rise from residual OVD, and reduced surgical cost.