ALTERATIONS TO THE ACRYSOF INTRAOCULAR-LENS DURING FOLDING

Purpose: To determine the frequency and cause of scratches or marks on the AcrySof(R) intraocular lens (IOL). Setting: Centre SaintVictor, A miens Cedex, France. Methods: In a clinical study, an AcrySof IOL was implanted in four eyes using a McDonald-Livernois forceps. In an exper imental study, 50 sterile AcrySof IOLs were folded under a surgical mi croscope by one person; 40 were folded with a modified Steinert forcep s and 10, with a modified Buratto forceps. Results: Three IOLs implant ed in the clinical study had scratches, marks, or both. These were not ed during surgery but were not significant enough to justify explantat ion. They had no effect on recovery of vision. Of the 50 IOLs studied microscopically, 18 showed no defects; 32 had some alterations that we re difficult to assess because they were minimal or because more than one alteration appeared on the same lens. Conclusion: AcrySof IOLs are more fragile than silicone IOLs, although the alterations caused by f olding did not affect visual acuity in this study. To avoid complicati ons, the lens must be folded on the 6 to 12 o'clock axis and the hapti cs inserted one right after the other.