Injection time related to intraocular pressure using a CO2 driven preloaded injector: An experimental laboratory study.

Purpose: Experimental study to measure the intraocular lens (IOL) injection time and injection speed at different intraocular pressure (IOP) settings when using the AutonoMe® injector.
Methods: In this experimental study, following phacoemulsification in porcine cadaver eyes, a trocar was inserted at pars plana with a connected infusion and IOPs of 20, 50 and 80 mmHg were generated by altering the infusion height. Twelve CO2 gas-driven injectors were used to implant an IOL via a corneal incision of 2.2 mm. For each IOP setting, the duration of the IOL injection and the injection speed was measured by analyzing a video recording of the procedure.
Results: The mean ±SD injection time (seconds) was 4.47±0.50 at 20 mmHg, 4.98±0.55 at 50 mmHg and 5.47±0.20 at 80 mmHg. The mean ±SD injection speed (millimeters per seconds) was 1.36±0.15 at 20 mmHg, 1.22±0.14 at 50 mmHg and 1.10±0.04 at 80 mmHg. There was a significant (p<0.05) difference between the 20 and 80 mmHg groups in mean injection duration and injection speed.
Conclusion: The CO2 gas driven injector allows a safe IOL injection even at elevated IOP. Although the implantation time is slightly extended at higher IOPs, this does not seem to be clinically relevant. No IOL damage was observed at these pressure settings.
Competing Interests: JW, TN, and SS have nothing to disclose. GUA reports grants, personal fees, non-financial support and consulting fees from Alcon and Johnson&Johnson, grants, personal fees and non-financial support from, Hoya, Kowa, Oculentis/Teleon, Rayner, Santen, Sifi, Ursapharm, grants and personal fees from Biotech, EyeYon, Oculus, Ophtec, grants from Acufocus, Anew, Carl Zeiss Meditec, Contamac, Glaukos, Physiol, Rheacell; outside the submitted work. RK reports grants, personal fees and non-financial support from Alimera, Alcon, Bayer, Johnson&Johnson, Hoya, Novartis, Physiol, Rayner and Roche, grants from Chengdu Kanghong, personal fees and non-financial support from Allergan, Kowa, Oculentis/Teleon, Oculus, Santen, and Acufocus; outside the submitted work. There are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.