Injector provides predictable, controlled delivery, placement of IOL

Take-Home

A newly introduced reusable injector system simplifies delivery and placement of a glistening-free, hydrophobic acrylic IOL in the experience of one ophthalmologist.

By Lynda Charters; Reviewed by Baseer Khan, MD, FRCSC

Toronto-With the introduction of a next-generation reusable IOL injector system (Bausch + Lomb Injector System [BLIS]), cataract surgeons have a new instrument in their armamentarium.

Baseer Khan, MD, FRCSC, shared his early experiences with the injector system, which he began using in fall 2013. The device, officially introduced in the United States in February, is designed specifically for use with a glistening-free, hydrophobic acrylic IOL (enVista, Bausch + Lomb).

Though the previous injector system was disposable, Dr. Khan noted that IOLs are much easier to load into the cartridge with this newest generation.

“There is a small notch in the cartridge that helps the leading haptic to fold onto itself, which happens automatically with lens insertion,” said Dr. Khan, assistant professor of ophthalmology, University of Toronto.

New-generation improvements

In previous generations, the IOL haptics could be compressed in the loading mechanism, or get pinched between the cartridge and the plunger tip-either scenario potentially resulting in amputation of the haptics on insertion, Dr. Khan noted.

The injector is a two-piece system with screw technology rather than plunger technology, which, according to Dr. Khan, has been widely adopted by ophthalmologists. Its handpiece is reusable.

“The delivery of the IOL is very controlled with [this] injector,” Dr. Khan said.

The first disposable injector for the EnVista IOL injector caused the lens to torque slightly during insertion, and the surgeon had to turn his or her wrist 180º to ensure that the lens was delivered right side up, he said.

“That doesn’t happen with this injection system,” Dr. Khan said.

As with previous generations, this new injector can deliver the lens through a 2-mm incision.

Surgical pearls

Dr. Khan advised surgeons using the new injector to make certain the IOL is positioned as far down in the cartridge as possible by pushing it forward with a pair of straight tying forceps.

If the IOL is not as far into the cartridge as possible, the plunger can sometimes engage the haptics in such a way that the haptics can be sheared, he said.

Though the instrument was designed for use with the enVista lens, other IOLs also can be injected using this system, according to Dr. Khan.

“Before other injector systems were introduced, other companies were using the Monarch injector [Alcon Laboratories] to insert their IOLs,” he said. “In this case, other IOLs with a similar one-piece optics design should be able to be injected with the BLIS system.

“I’ve found [the new injector system] facilitates smooth loading as well as an effortless delivery of the lens,” Dr. Khan said. “The design of the cartridge also enhances the insertion of the IOL in comparison to other technologies on the market. This device lives up to its name and is a welcome addition in my practice.”

Baseer Khan, MD, FRCSC

E: baseer.khan@mac.com

Dr. Khan is a consultant to Bausch + Lomb. BLIS was approved by Health Canada in August 2013 and received CE Mark approval in October 2013.

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