Research Article
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Comparison of Two Separate Folding Methods Applied to Intraocular Lenses Used in Cataract Surgery in Terms of Mechanical Damage to the Lens and Causing Complications

Year 2025, Volume: 14 Issue: 2, 243 - 250, 30.08.2025

Abstract

Abstract
Aim: In this study, it was aimed to compare the foldable intraocular lenses used in cataract surgeries in terms of mechanical damage to the lens as a result of two separate folding techniques applied by the scrub nurse and the formation of lens-related intraocular surgical complications during surgery.
Methods: It is a comparative observational study. 150 patients (88 men, 62 women) who received surgical indication as a result of senile cataract were included in the study. The X-folding technique was applied to the first group of 75 patients, and the Y-folding technique was applied to the second group of 75 patients. Preoperative and postoperative information about the patient was collected at the end of each surgery. Chi-square test was used for statistical significance between two qualitative variables. Statistical significance was accepted as p <0.05.
Findings: While mechanical damage to the lens was less common in the patient group using the X technique, lens-related intraocular surgical complications were less common in the patient group using the Y technique. The differences between the two techniques were not found to be statistically significant p>0.05.
Results: It can be said that the effects of both lens folding techniques on the mechanical damage of the lens and the formation of lens-related intraocular surgical complications during surgery are similar.

Ethical Statement

All the authors of this article declare that they have no conflicts of interest. . Ethics Committee approval numbered 2021/80 and written consent from patients were obtained from Haydarpaşa Numune Training and Research Hospital Clinical Research Ethics Committee for this research. Verbal and written consent was obtained from each participant before the study, and they were asked to fill in the informed consent form, and only the participants who gave consent were included in the study.

Supporting Institution

none

Project Number

none

Thanks

We gratefully would like to thank all the patients participating in the research.

References

  • Aslan, S. B., Gücükoğlu, A. (2005). Göz içi lens uygulaması ve araçları. In H. Özçetin, Katarakt ve Tedavisi. Bursa: Uludag University Faculty of Medicine, Department of Ophthalmology.
  • Bainbridge, J. W., Teimory, M., Tabandeh, H., Kirwan, J. F., Dalton, R., Reid, F., & Roston, C. K. (1998). Intraocular lens implants and risk of endophthalmitis. British Journal of Ophthalmology, 82(11), 1312-1315. https://doi.org/10.1136/bjo.82.11.1312
  • Davis, G. (2016). The evolution of cataract surgery. Missouri Medicine, 113(1), 58-62.
  • EyeCryl Plus (2022). Monofocal Hydrophilic Acrylic Foldable Intraocular Lens [Brochure]. https://www.biotechhealthcare.com.tr/wp-content/uploads/2022/08/EYECRYL-PLUS-600-%E2%94%82-FLYER-%E2%94%82-MKT1042-%E2%94%82-REV13.3-%E2%94%82-16-08-2022-%E2%94%82-PRINT-FILE-%E2%94%82-ENGLISH.pdf
  • Gözüm, N. (2012). Katarakt ve tedavisi. Klinik Gelişim, 25, 12-15.
  • Halkiadakis, L., Ntravalias, T., Chatzistefanou, K., Kandarakis, S., Patsea, E. (2023). Screening cataract patients in a public hospital for a multifocal ıntraocular lens ımplantation. Research Square, 1-12. https://doi.org/10.21203/rs.3.rs-3400407/v1
  • Hesse, Y., Freissler, K. A., & Lang, G. K. (2001). Scanning electron microscopic study of 12 lenses of two types of soft acrylic intraocular lenses. Klin Monbl Augenheilkd, 218(10), 682-687. https://doi.org/10.1055/s-2001-18391
  • Kelman, C. (1994). The history and development of phacoemulsification. International Ophthalmology Clinics, 34(2), 1-12. https://doi.org/10.1097/00004397-199403420-00002
  • Kleinmann, G., & Apple, D. J. (2007). Evaluation of a new soft tipped injector for the implantation of foldable intraocular lenses. British Journal of Ophthalmology , 91(8), 1070-1072. https://doi.org/10.1136/bjo.2006.103192
  • Kleinmann, G., Marcovich, A. L., Apple, D. J., & Mamalis, N. (2005). Linear deposits on the surfaces of intraocular lenses implanted through a hexagonal cartridge which mimic scratches/cracks on the lenses. British Journal of Ophthalmology , 89(11), 1474-1477. https://doi.org/10.1136/bjo.2005.071738
  • Leaming, D. V. (1999). Practice Styles and preferences of ASCRS members-1998 survey. Journal of Cataract and Refractive Surgery, 25(6), 459-467.
  • Lindstrom, R. (2015). Thoughts on cataract surgery. Review of Ophthalmology.
  • Milazzo, S., Turut, P., Blin, H. (1996). Alterations to the acrysof intraocular lens during folding. Journal of Cataract and Refractive Surgery, 22(2), 1351-1354.
  • Myers, T. D., & Olson, R. J. (1999). Comparison of the effects of viscoelastic agents on clinical properties of the unfolder lens injection system. Journal of Cataract and Refractive Surgery, 25(7), 953-958.
  • Nguyen, D. Q., Saleh, T. A., Pandey, S. K., Bates, A. K. (2006). Irregularities on the surface of single-piece Acrysof Sa60at intraocular lenses. Journal of Cataract and Refractive Surgery, 32(3), 495-498. https://doi.org/10.1016/j.jcrs.2005.12.074
  • Oshika, T., Nagahara, K., Yaguchi, S., Emi, K., Takenaka, H., Tsuboi, S., Yoshitomi, F., Nagamoto, T., Kurosaka, D. (1998). Three year prospective, randomized evaluation of intraocular lens implantation through 3.2 and 5.5 mm incisions. Journal of Cataract and Refractive Surgery, 24(4), 509-514. https://doi.org/10.1016/s0886-3350(98)80293-9.
  • Shimizu, K., Kobayashi, K., Takayama, S., Zhaobin, G. (2008). Preloaded injector for intraocular lens implantation without the use of ophthalmic viseosurgical devices. Journal of Cataract and Refractive Surgery, 34(7), 1157-1160. https://doi.org/10.1016/j.jcrs.2008.03.034
  • Singh, A. D., Fang, T., Rath, R. (1999). Cartridge cracks during foldable intraocular lens insertion. Journal of Cataract and Refractive Surgery, 24(9), 1220-1222. https://doi.org/10.1016/s0886-3350(98)80015-1
  • Stefaniu, I., Nita, N., Lazar, S., Dragan, I., Barlea, G., Balan, L., Hagima, N. (2003). Acrylic IOL implantation with the Monarch II Injector. Oftalmologia, 59(4), 42-45.
  • Tekin, K., Çıtırık, M., Üzel, M., İlhan, Ç. (2016). Fakoemülsifikasyon cihazı, çalışma prensipleri ve parametreler. Glokom Katarakt, 11(1), 73-84.
  • Ultraviolet Radiation. (2022). Retrieved March 2022 from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/ultraviolet-radiation
  • Yülek, F., Orhan, N., Koçak Altıntaş, A. G., Şimşek, Ş. (2007). Katlanabilir göz içi lenslerde katlantı izi. Turkish Medical Journal, (1), 37-40.
  • Zhang, M., Ji, M., Tan, M., Yu, Y., Guan, H. (2023). Evaluation of fundus function in mature cataract patients by visual electrophysiology. Hindawi Journal of Ophtalmology, 1-2. https://doi.org/10.1155/2023/9065094

Year 2025, Volume: 14 Issue: 2, 243 - 250, 30.08.2025

Abstract

Project Number

none

References

  • Aslan, S. B., Gücükoğlu, A. (2005). Göz içi lens uygulaması ve araçları. In H. Özçetin, Katarakt ve Tedavisi. Bursa: Uludag University Faculty of Medicine, Department of Ophthalmology.
  • Bainbridge, J. W., Teimory, M., Tabandeh, H., Kirwan, J. F., Dalton, R., Reid, F., & Roston, C. K. (1998). Intraocular lens implants and risk of endophthalmitis. British Journal of Ophthalmology, 82(11), 1312-1315. https://doi.org/10.1136/bjo.82.11.1312
  • Davis, G. (2016). The evolution of cataract surgery. Missouri Medicine, 113(1), 58-62.
  • EyeCryl Plus (2022). Monofocal Hydrophilic Acrylic Foldable Intraocular Lens [Brochure]. https://www.biotechhealthcare.com.tr/wp-content/uploads/2022/08/EYECRYL-PLUS-600-%E2%94%82-FLYER-%E2%94%82-MKT1042-%E2%94%82-REV13.3-%E2%94%82-16-08-2022-%E2%94%82-PRINT-FILE-%E2%94%82-ENGLISH.pdf
  • Gözüm, N. (2012). Katarakt ve tedavisi. Klinik Gelişim, 25, 12-15.
  • Halkiadakis, L., Ntravalias, T., Chatzistefanou, K., Kandarakis, S., Patsea, E. (2023). Screening cataract patients in a public hospital for a multifocal ıntraocular lens ımplantation. Research Square, 1-12. https://doi.org/10.21203/rs.3.rs-3400407/v1
  • Hesse, Y., Freissler, K. A., & Lang, G. K. (2001). Scanning electron microscopic study of 12 lenses of two types of soft acrylic intraocular lenses. Klin Monbl Augenheilkd, 218(10), 682-687. https://doi.org/10.1055/s-2001-18391
  • Kelman, C. (1994). The history and development of phacoemulsification. International Ophthalmology Clinics, 34(2), 1-12. https://doi.org/10.1097/00004397-199403420-00002
  • Kleinmann, G., & Apple, D. J. (2007). Evaluation of a new soft tipped injector for the implantation of foldable intraocular lenses. British Journal of Ophthalmology , 91(8), 1070-1072. https://doi.org/10.1136/bjo.2006.103192
  • Kleinmann, G., Marcovich, A. L., Apple, D. J., & Mamalis, N. (2005). Linear deposits on the surfaces of intraocular lenses implanted through a hexagonal cartridge which mimic scratches/cracks on the lenses. British Journal of Ophthalmology , 89(11), 1474-1477. https://doi.org/10.1136/bjo.2005.071738
  • Leaming, D. V. (1999). Practice Styles and preferences of ASCRS members-1998 survey. Journal of Cataract and Refractive Surgery, 25(6), 459-467.
  • Lindstrom, R. (2015). Thoughts on cataract surgery. Review of Ophthalmology.
  • Milazzo, S., Turut, P., Blin, H. (1996). Alterations to the acrysof intraocular lens during folding. Journal of Cataract and Refractive Surgery, 22(2), 1351-1354.
  • Myers, T. D., & Olson, R. J. (1999). Comparison of the effects of viscoelastic agents on clinical properties of the unfolder lens injection system. Journal of Cataract and Refractive Surgery, 25(7), 953-958.
  • Nguyen, D. Q., Saleh, T. A., Pandey, S. K., Bates, A. K. (2006). Irregularities on the surface of single-piece Acrysof Sa60at intraocular lenses. Journal of Cataract and Refractive Surgery, 32(3), 495-498. https://doi.org/10.1016/j.jcrs.2005.12.074
  • Oshika, T., Nagahara, K., Yaguchi, S., Emi, K., Takenaka, H., Tsuboi, S., Yoshitomi, F., Nagamoto, T., Kurosaka, D. (1998). Three year prospective, randomized evaluation of intraocular lens implantation through 3.2 and 5.5 mm incisions. Journal of Cataract and Refractive Surgery, 24(4), 509-514. https://doi.org/10.1016/s0886-3350(98)80293-9.
  • Shimizu, K., Kobayashi, K., Takayama, S., Zhaobin, G. (2008). Preloaded injector for intraocular lens implantation without the use of ophthalmic viseosurgical devices. Journal of Cataract and Refractive Surgery, 34(7), 1157-1160. https://doi.org/10.1016/j.jcrs.2008.03.034
  • Singh, A. D., Fang, T., Rath, R. (1999). Cartridge cracks during foldable intraocular lens insertion. Journal of Cataract and Refractive Surgery, 24(9), 1220-1222. https://doi.org/10.1016/s0886-3350(98)80015-1
  • Stefaniu, I., Nita, N., Lazar, S., Dragan, I., Barlea, G., Balan, L., Hagima, N. (2003). Acrylic IOL implantation with the Monarch II Injector. Oftalmologia, 59(4), 42-45.
  • Tekin, K., Çıtırık, M., Üzel, M., İlhan, Ç. (2016). Fakoemülsifikasyon cihazı, çalışma prensipleri ve parametreler. Glokom Katarakt, 11(1), 73-84.
  • Ultraviolet Radiation. (2022). Retrieved March 2022 from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/ultraviolet-radiation
  • Yülek, F., Orhan, N., Koçak Altıntaş, A. G., Şimşek, Ş. (2007). Katlanabilir göz içi lenslerde katlantı izi. Turkish Medical Journal, (1), 37-40.
  • Zhang, M., Ji, M., Tan, M., Yu, Y., Guan, H. (2023). Evaluation of fundus function in mature cataract patients by visual electrophysiology. Hindawi Journal of Ophtalmology, 1-2. https://doi.org/10.1155/2023/9065094
There are 23 citations in total.

Details

Primary Language English
Subjects Surgical Diseases Nursing​​
Journal Section Articles
Authors

Ayşen Demirel 0000-0001-8510-0825

Seher Yurt 0000-0001-9972-3273

Project Number none
Publication Date August 30, 2025
Submission Date February 1, 2024
Acceptance Date March 24, 2025
Published in Issue Year 2025 Volume: 14 Issue: 2

Cite

APA Demirel, A., & Yurt, S. (2025). Comparison of Two Separate Folding Methods Applied to Intraocular Lenses Used in Cataract Surgery in Terms of Mechanical Damage to the Lens and Causing Complications. Balıkesir Sağlık Bilimleri Dergisi, 14(2), 243-250. https://doi.org/10.53424/balikesirsbd.1430064

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