University of Iowa Health Care

Ophthalmology and Visual Sciences

EyeRounds.org

Intraocular Lenses (IOL) Folding and Insertion

Objectives

  • Fold 7 single piece acrylic (SPA) IOLs in the wet lab using Monarch injector.
  • Fold 5 three-piece IOL in the wet lab using the Monarch injector.
  • To fold and insert a single piece acrylic intraocular lenses into a kitaro eye
  • Describe the advantages/disadvantages of the SPA vs. 3 Piece IOL.
  • Know the answers to these questions:
    • Which Monarch cartridge is used for:
      • a SN60WF SPA IOL?
      • a MA50 three piece acrylic IOL?
    • What are the sizes of the Monarch A-D cartridges?
    • How do you know if an IOL is upside down?
    • Describe all of the information on an IOL calculation sheet

Reading

  • Henderson BA. Essentials of Cataract Surgery, second edition. Thorofare, NJ: Slack Inc., 2014. (WW 260 E78 2014). isbn 978-1-61711-0672
    • Chapter 16, Intraocular Lens Calculations, Pages 156-166
      (UIHC Link)
    • Chapter 17, Intraocular Lens Design, Material, and Delivery, Pages 167-182
      (UIHC Link)

Videos

Folding and inserting Single piece acrylic (SPA) IOLs

Folding SPA
Watch on YouTube

 

Loading the SA60
Eyepod Video Watch on YouTube

 

Loading the AcrySof Natural
Watch on YouTube

 

Folding and inserting 3 piece IOLs

Loading the MA 50 (3-piece IOL)
Watch on YouTube

 

IOL placement and centration (including sulcus placement)
Watch on YouTube

 

MA 50 in sulcus with optic capture
Watch on YouTube

 

Loading the Alcon MA50 lens for cataract surgery
Watch on YouTube

Flipping IOL placed upside down:

Backing in backwards
Watch on YouTube

 

Flipping the IOL
Watch on YouTube

 

Removing IOL:

Remove marred IOL
Watch on YouTube

 

SN What the F
Watch on YouTube

Other tips related to IOL insertion:

Almost done
Watch on YouTube

 

Utratta for stuck haptic
Watch on YouTube

 

Diablo's hook
Watch on YouTube


Simulation

EYE MODEL


EQUIPMENT

  • C or D cartridge for SPA
  • B cartridge for 3-piece
  • Monarch injector (blue preferred)
  • Viscoelastic (ocucoat, viscoat, healon)
  • Kellman-McPherson forceps (or straight tie forceps)

EYESI

IOL insertion Module

  • Pros: allows for repetition
  • Cons: very easy to pop the IOL in the bag with inserter (rarely this easy in real surgery), hard to practice viscoelastic removal beneath the IOL.

Suggested citation format: Haugsdal J, Kitzmann A, Oetting TA. The Iowa Ophthalmology Wet Laboratory. EyeRounds.org. Updated Posting June 28, 2021. Originally Posted December 6, 2012. Available from http://www.EyeRounds.org/tutorials/Iowa-OWL-o2021/

last updated: 07/01/2021