Incision sizes before and after implantation of SN60WF intraocular lenses using the Monarch injector system with C and D cartridges

PURPOSE: To evaluate incision sizes for 6.0 mm optic hydrophobic acrylic intraocular lenses (IOLs) implanted with different injector systems and surgical techniques. SETTING: Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt, Germany. METHODS: In this prospective randomized trial of 100 cataract patients, hydrophobic acrylic IOLs (SN60WF) were implanted using 2 injector systems with 2 cartridges (Monarch II and Monarch III with C and D cartridges, respectively; Alcon) and 2 surgical techniques (direct implantation and wound-assisted docking implantation). Incision sizes were measured before and after phacoemulsification as well as before and after IOL implantation using a Tsuneoka microincision gauge. The Saphiro-Wilks test was performed to detect nonparametric distribution and the Kruskal-Wallis test, to test for significant differences between groups. RESULTS: The mean incision sizes (mm) at the 4 points of treatment with the Monarch III with the D cartridge were 1.98 +/- 0.07, 2.01 +/- 0.05, 2.42 +/- 0.07, and 2.51 +/- 0.05, respectively, with direct implantation and 1.92 +/- 0.06, 1.98 +/- 0.04, 2.02 +/- 0.11, and 2.09 +/- 0.11, respectively, with wound-assisted implantation. With the Monarch 11 with the C cartridge, the mean incision sizes were 2.17 +/- 0.06, 2.2 +/- 0.16, 2.77 +/- 0.11, and 2.86 +/- 0.11, respectively, with direct implantation and 2.12 +/- 0.10, 2.17 +/- 0.19, 2.19 +/- 0.09, and 2.28 +/- 0.08, respectively, with wound-assisted implantation. Postoperative incision sizes differed significantly from preoperative incision sizes and from each other (P <.05). CONCLUSION: With new injector systems and an appropriate docking implantation technique, foldable hydrophobic acrylic IOLs can be implanted through 2.0 mm tunnel incisions.