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Lens and injector offer reliability, good visual results
Their design and material ensure safe, controlled delivery, perfect centration in response to capsule shrinkage and optimal visual quality.
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CUNEO, Italy – A combination of a hydrophilic acrylic IOL and an injector system offers excellent visual and surgical results, according to a surgeon here.
Guido Caramello, MD, reported excellent visual results, a low rate of posterior capsular opacification, no intraoperative complications and no glare in a series of 20 patients implanted with the BL27 IOL using the Hydroport injector system (both from Bausch & Lomb).
“The lens and its single-use injector are specially designed to fit one another and to simplify the insertion procedure. It is a very safe and reliable system that allows implantation through very small incisions,” Dr. Caramello said.
The BL27 is placed in the cartridge delicately with forceps, he said.
“I usually lubricate the injector with a drop of viscoelastic first, then load it with the IOL. I close the device and inject a second drop of visco through the tip. As with all injectors, you need a some time to get familiar with the procedure, but once you have learned, the maneuvers are easy and reproducible,” he said.
A smooth procedure
Dr. Caramello’s series included 12 women and eight men with a mean age of 67.6 years. Two patients with ocular hypertension, two with diabetes and one with glaucoma were included.
“I performed a 4.5-mm to 5-mm capsulorrhexis and used the Bausch & Lomb Millennium with venturi pump for phacoemulsification. Mean ultrasound time was 25 seconds,” Dr. Caramello said.
Implantation of the IOL was carried out through a 3-mm incision.
“By applying a slow, constant pressure on the plunger, the lens unfolded smoothly and gently in the capsular bag. The material of this IOL is soft and foldable, and you can see it regaining its shape naturally while it frees itself from the extreme compression of the cartridge. I applied a light pressure on the optic to help positioning of the lens, which was perfectly centered and stable in all eyes, with the rhexis well inside the optic edge,” he said.
Satisfactory results
At 1 month, mean uncorrected visual acuity in the eyes was 20/35 and mean best corrected visual acuity was 20/25, Dr. Caramello said. The lens was well centered and perfectly transparent, and patient satisfaction was very high. There was no complaint of glare or disturbance while driving at night, he added.
At 1 year there were no negative variations of visual acuity, no glare and no problems with dislocation. Only 1 case of posterior capsule opacification treated with YAG laser capsulotomy was reported.
“In the BL27, not only the optic, but also the haptics are square-edged, and therefore they block cell proliferation in the periphery,” Dr. Caramello said. “We had six cases of lens epithelial cell proliferation, probably connected with small a capsulorrhexis size. However, two of these patients had diabetes and one had glaucoma, and these conditions almost surely contributed to this outcome. On the other hand, no sign of fibrosis was observed in 13 cases.”
The BL27 IOL and Hydroport injector are currently not available for use in the United States.
For Your Information:
- Guido Caramello, MD, is head of the Cuneo Hospital Eye Clinic. He can be reached at Azienda Ospedaliera S. Croce, Via Michele Coppino 26, 12100 Cuneo, Italy; tel/fax: +(39) 0171-441-295/441-256. Ocular Surgery News could not confirm whether Dr. Caramello has a direct financial interest in any of the products mentioned in this article or if he is a paid consultant for any company mentioned.
- Bausch & Lomb can be reached at Hamilton House (Block B), Regent Park, Kingston Rd., Leatherhead, Surrey, KT22 7PQ UK; +(44) 1372-22-4030.