Stefaniu I, Nita Neboisa, Lazar Sanda, Dragan Irina, Barlea Gabriela, Balan Laura, Hagima Narcisa
Spitalul Clinic de Urgenta Militar Central, Bucuresti.
Oftalmologia. 2003;59(4):42-5.
To study the technical difficulties using the MONARCH II injector, intraoperative incidents, postoperative astigmatism.
Retrospective study which included 135 eyes with cataract who underwent cataract surgery between March 2002-August 2003. The surgical intervention consisted of lens extraction by phacoemulsification technique and IOL implantation with the MONARCH II injector. We recorded the following parameters: problems during the loading of the IOL in the cartridge, difficulties during the implant, problems due to the damage of the IOL during the passage in the cartridge, IOL centration in the capsular bag, induced postoperative astigmatism.
We had no major difficulties using this type of injector. We did not recorded important differences between the hydrophobic and hydrophilic IOLs. We had a number of 17 intraoperative incidents (12.6%). We met the following intraoperative incidents: the last haptic capture in the tunnel of the cartridge in 5 cases (3.7%), small marks on the optic surface left by the tip of the injector in 3 cases (2.2%), the leading haptic stuck on the optic surface in 2 cases (1.4%), breaking of the last haptic (multi-piece IOL) in 1 case (0.7%), the turning up side down of IOL during unfolding (hydrophilic IOLs) in 6 cases (4.4%). Postoperative astigmatism was less than 1D cylinder in 88% of cases.
The IOL implantation using MONARCH II injector is easy and doesn't need learning curve. The technique is superior compared with forceps implantation (especially for acrylic hydrophilic IOLs). No significant differences between implantation of acrylic IOLs. IOL centration was good. The design of the injector tip preserved optic surface and haptic from damage. The conical tip of the cartridge didn't change the architecture of the corneal wound. The postoperative astigmatism was small.
研究使用MONARCH II注入器的技术难点、术中事件及术后散光情况。
回顾性研究，纳入2002年3月至2003年8月期间接受白内障手术的135例白内障患者的眼睛。手术干预包括采用超声乳化技术摘除晶状体，并使用MONARCH II注入器植入人工晶状体。我们记录了以下参数：人工晶状体装入药筒时的问题、植入过程中的困难、人工晶状体在药筒通道中通过时因损坏导致的问题、人工晶状体在囊袋中的居中情况、术后诱导散光。
使用这种类型的注入器我们没有遇到重大困难。我们没有记录到疏水型和亲水型人工晶状体之间的重要差异。我们有17例术中事件（12.6%）。我们遇到了以下术中事件：5例（3.7%）人工晶状体的最后一个袢在药筒通道中被卡住，3例（2.2%）注入器尖端在光学表面留下小痕迹，2例（1.4%）前袢卡在光学表面，1例（0.7%）最后一个袢断裂（多片式人工晶状体），6例（4.4%）亲水性人工晶状体在展开过程中发生翻转。88%的病例术后散光小于1D柱镜。
使用MONARCH II注入器植入人工晶状体操作简便，无需学习曲线。与镊子植入相比，该技术更具优势（尤其是对于丙烯酸亲水性人工晶状体）。丙烯酸人工晶状体植入之间无显著差异。人工晶状体居中良好。注入器尖端的设计可保护光学表面和袢不受损伤。药筒的锥形尖端不会改变角膜伤口的结构。术后散光较小。
