Preloaded IOL injector simplifies lens implantation

The single-piece aspheric 6-mm lens is designed for insertion through a sub-2.4 mm incision.

In part two of a series of articles on new developments presented at the OSN Technology and Equipment Workshop 2010, Joseph T. Russell, vice president for U.S. sales and marketing, Hoya Surgical Optics, discussed the iSert preloaded IOL injection system.

“The iSert is the first preloaded lens available in the U.S. that allows for a hydrophobic acrylic lens to go through a sub-2.4 mm incision,” Mr. Russell said.

The injection system is completely self-contained, which enhances intraoperative safety, efficiency and predictability, he said.

“The lens is always in the same place all the time,” Mr. Russell said. “The technician doesn’t have to load the lens. And so when it’s time to actually put the lens in the position to hand to the surgeon, it’s done in a very, very efficient and predictable manner.”

Hoya Surgical Optics introduced the iSert to the U.S. market in August 2009. The system had been marketed in Europe and Japan since 2007.

On average, the sale price of the lens is equivalent to that of other aspheric lenses, Mr. Russell said.

“And you’ll not see an add-on because of the benefit of the preloaded lens,” he said.

The lens qualifies for new technology IOL reimbursement, Mr. Russell said.

Features of aspheric lens

The 6-mm aspheric hydrophobic acrylic lens is untouched by human hands from the time it is loaded into the injector at the factory until it is injected into the eye, Mr. Russell said.

“There is no loading of the IOL in the operating room,” he said. “And the first time that lens is touched from manufacturing is actually when the lens goes into the patient’s eye. It’s a very clever device.”

In addition, the single-use disposable injection system may reduce the risk of toxic anterior segment syndrome and other complications understood to be associated with reusable insertion instruments, Mr. Russell said.

The one-piece lens is made of two materials. The haptics are fashioned from PMMA, and the optic is made of hydrophobic acrylic. The lens has –0.18 µm of asphericity and is tinted for blocking UV or blue light.

“It’s a very unique manufacturing process, so that the haptics are not staked inside the IOL,” Mr. Russell said. “The two materials are fused together and then it’s lathe cut, tumble polished. It’s a beautiful lens when you see it in the eye.”

Insertion technique

During the process of engaging the lens before injection into the eye, the scrub technician flushes it with balanced saline solution and injects 0.2 mL of viscoelastic through the infusion port to lubricate movement of the IOL into the barrel of the cartridge.

Most viscoelastic materials are suitable except Healon5 (Abbott Medical Optics) because the highly viscous material may impede the forward extension of the haptic during movement of the IOL into the barrel.

After sliding the lens into the barrel of the injector nozzle, the technician engages the plunger, which pushes the lens to the end of the injector tip.

As the lens moves to the tip of the injector, the surgeon inserts the tip through the incision, under the anterior capsule and into the bag. – by Matt Hasson

• Joseph T. Russell can be reached at Hoya Surgical Optics, Global Headquarters, 14768 Pipeline Ave., Chino Hills, CA 91709; 909-680-3900; fax: 866-750-5870; e-mail: joe.russell@hoyasurgopt.com.