Preloaded IOL systems can save almost 30 seconds of operating time in cataract surgery, according to Damien Goldberg, MD, who participated in a trial with a preloaded delivery system (AcrySof IQ IOL Model AU00TO with UltraSert, Alcon Laboratories).
“This is the direction to go,” said Dr. Goldberg, who practices in Torrance, CA. “It’s more and more critical to be efficient in the operating room.
“Most of us in surgery centers have very good techs who are comfortable loading these lenses, but not everybody does, and having these lenses preloaded would make it easier for people,” he added.
To see whether preloaded IOL delivery can save time, Dr. Goldberg and colleagues in Belleville, IL, Durham, NC, and Stillwater, MN, used video cameras to record implantation of 84 AcrySof IQ IOLs preloaded in the UltraSert cartridge and 84 AcrySof IQ IOLs in the Monarch D Cartridge (Alcon) in adult patients undergoing cataract surgery.
The two lenses are identical except the UltraSert comes from the manufacturer already loaded in its injector, whereas the Monarch must be loaded, typically by a surgical technician. The lenses were all basic monofocal IOLs.
Researchers clocked three surgical stages:
1. Device preparation time from the moment the nurse or assistant signaled the initiation of the device preparation until the device touched the eye.
The mean time was 43.0 seconds with the Monarch versus 21.6 seconds with the UltraSert. The difference was statistically significant (p < 0.25). The median time was 38.0 seconds for the Monarch and 10.0 seconds for the UltraSert.
“Obviously, the tech preparing the lens is a lot faster . . . just to put the viscoelastic in the cartridge and get the implant all ready,” Dr. Goldberg said.