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
Bad day
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
- Phillips IOL insertion PS-014
- Phillips Sulcus IOL PS-035 (currently no product info online)
- Kitaro Wet Lab kit
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/
