The surgery has gone very smoothly and the senior resident is doing a great job. The incisions are good, the capsulorhexis is round and intact, and the nucleus was phacoemulsified successfully. Lens cortex has been removed and the capsular bag is now inflated with cohesive viscoelastic in preparation for IOL insertion.
The decision was made to implant a three-piece, monofocal, acrylic IOL into the capsular bag. The lens was loaded into the cartridge and injected into the eye and that’s when he realized that the leading haptic was not unfolding. The mistake he made was assuming that the three-piece IOL should be loaded the same way as a single-piece IOL. He made the incorrect assumption that the leading haptic could be folded over the optic and that it would bounce back, similar to a single-piece IOL. This is not the case.
As we have explained in previous videos, the loading of a three-piece IOL is not the same as a single-piece IOL. This is due to the nature of the haptics which are far more delicate and prone to damage. Unlike a single-piece IOL, these thin, blue haptics will not bounce back to their original shape or position. So now what is your solution?
Click below to see how we remedied this situation and successfully completed the case:
A very useful tip. Thanks for the video. three piece IOLs of different manufacturers have a different loading technique.