Sealed implantation of foldable intraocular lenses

Purpose: To evaluate the safety and efficacy of sealed implantation, a simple technique for implanting foldable intraocular lenses (IOLs). Methods: This was a retrospective study including consecutive patients who underwent phacoemulsification cataract using the sealed implantation technique. Sealed implantation is a technique in which a single-piece, foldable IOL is implanted without an intraocular ophthalmic viscosurgical device (OVD) or continuous infusion (hydroimplantation) of balanced saline solution (BSS). Forty consecutive patients who underwent clear corneal incision cataract surgery with IOL implantation using this technique were included. A 3-step 2.75-mm incision was performed approximately 0.5 mm anterior to the limbus with a 1.50 to 1.75 mm length as well as a 0.9 mm side port incision. Prior to the insertion of the IOL, the capsular bag and anterior chamber are filled with BSS. Hydroxypropyl methylcellulose 2% is applied external to the main corneal incision. The foldable IOL injector tip is introduced into the main incision in one quick jabbing motion and the IOL injected. The IOL is dialed with a standard irrigating Simcoe cannula. The main outcomes were intraoperative complications and postoperative hypotony. Results: Of 50 charts reviewed, sealed implantation was attempted in 40 (80%), with success in all cases. The injection of the IOL was performed without anterior chamber loss in 92% of the cases (n = 36) and no complications were recorded. There were no events of postoperative hypotony or wound leakage. Conclusions: Sealed implantation is a safe and efficient alternative to hydroimplantation without the need for OVDs in suitable cases.