In the USA, the most commonly used IOL in routine cataract surgery is a single-piece acrylic IOL. These IOLs work very well but they must always be placed in the capsular bag as they are not suitable for placement in the sulcus. In addition, they come in a more limited range of powers, and may not be available for highly myopic eyes. Beginning surgeons must learn how to use three-piece IOLs because they come in a wider range of powers, can be placed in the sulcus if needed, and tend to offer more options for alternative placements such as reverse optic capture.
This is a basic video meant for surgeons in training (such as residents, fellows, and registrars) and this video shows one particular brand of IOL (Alcon AcrySof). There are other suitable three-piece IOLs in both acrylic and silicone which are loaded and implanted similarly.
When injecting the IOL, be mindful of the orientation of the leading haptic. If it comes out of the injector inverted, it will require rotation of the surgeon’s hand to position in properly.
Click below to watch this video to learn how to load and inject a three-piece IOL:
Thanks for sharing. I have used C cartridge many times for 3 piece lenses until one day it damaged the LEADING haptic of two consecutive lenses, not knowing the reason for that! Have you ever faced the same problem?
This can happen if the leading haptic gets kinked in the cartridge tip. Use a sinskey hook to go through the tip of the cartridge and pull the leading haptic straight before injecting the IOL
Do we have to revert the 3peace iol if placed upside down in sulcus?