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Modifications to a reusable injector system have reduced resistance between the plunger tip and the IOL, creating a smoother delivery of the lens into the eye.
Take-home message: Modifications to a reusable injector system have reduced resistance between the plunger tip and the IOL, creating a smoother delivery of the lens into the eye.
By Nancy Groves; Reviewed by Anil M. Shivaram, MD
Claremont, CA-A series of small modifications to a lens injector system (BLIS Injector System, Bausch + Lomb)-designed for use with a glistening-free hydrophobic acrylic IOL (enVista, Bausch + Lomb)-add up to huge improvements compared with the original system, said Anil M. Shivaram, MD.
“The previous iteration of the delivery system was not as optimized as it could be in terms of the delivery of the lens,” said Dr. Shivaram, an ophthalmologist in Claremont, CA, who has performed more than 80 procedures with the recently released updated injector.
“I think [the manufacturer] was getting feedback from myself and a number of other surgeons that they wanted to maximize the utility of the delivery system with the idea that eventually there will be an array of lenses that can be used with it,” Dr. Shivaram said.
One change is a longer plunger. With the additional 2 mm of length, it is easier for the surgeon to “dunk” and manipulate the lens when it is in the capsular bag, Dr. Shivaram said. The modified injector also has a polished, softened plunger tip to reduce resistance between it and the lens.
Though the previous version of the injector system was left-biased to increase compression on the haptic, the plunger tip has been repositioned and centered to instead reduce pressure in the optic-haptic junction. A slight downward angulation has been added to make sure the trailing haptic stays within the folded portions of the optic but without creating stress on that junction.
The external finish was also changed to provide more tactile feedback, a feature many surgeons appreciate, Dr. Shivaram said.
With any lens injector system, surgeons can potentially lose control of the lens. This can happen, for example, when there is too little viscoelastic in the cartridge, causing air pockets and forcing the lens to express faster than expected into the eye. The updated device ensures controllable, repeatable deliveries with little to worry about, he noted.
“It allows for minimizing that uncontrolled delivery,” Dr. Shivaram said. “You get a nice, smooth delivery of the lens without placing a lot of tension on the optic-haptic junction.”
The injector can be used through incisions as small as 2.2 mm, he noted.
Based on his experience with the new system, the changes have optimized delivery of the lens, Dr. Shivaram said.
Although currently only used with one IOL model, the recent improvements in the injector system and any future modifications could eventually extend its utility to an entire family of lenses, he added.
Anil M. Shivaram, MD
Dr. Shivaram is a consultant for Bausch + Lomb.