Why did the IOL Haptic get stuck to the Optic?


Haptic stuck to optic 171 title

We use thin IOLs which are then placed into injectors which roll, fold, or compress the them so that they can pass through our small incisions, typically 2 to 3 mm in width.

Why did the IOL haptic get stuck to the optic of this IOL? Simple answer is an insufficient amount of viscoelastic in the injector cartridge. The IOL must be lubricated with viscoelastic in order to be pushed down the cone-shaped tip of the injector cartridge. This surgical assistant has traditionally used the dispersive viscoelastic to coat the IOL and lubricate the injector, but since this is a larger myopic eye, there was an insufficient amount remaining.

When the IOL was injector, the trailing haptic stuck to the optic and would not release. This hydrophobic acrylic lens material is slightly tacky and it tends to stick to itself and also the the lens capsule (which is useful in maintaining IOL optic position and orientation). The better solution would have been to ask for more viscoelastic: either for some of the cohesive viscoelastic that was already on the surgical field, or even for another tube of dispersive viscoelastic. As the saying goes, viscoelastic is cheaper than vitreous!

Click below to watch this video of a stuck IOL haptic:  (you can forward to the action at 3:00)

All content is © 2018 by Uday Devgan MD. All rights reserved.

Leave a Reply