Descemet's tear due to injector cartridge tip deformity
Cartridge shaft deformity
I read with interest an article by Biswas et al., on descemet's tear due to injector cartridge deformity. I congratulate the authors for the suggestions given to avoid such a mishap. The authors described the situation were injector used was probably reusable for hydrophobic intraocular lenses (IOL).
I would like to share a situation were the cartridge shaft broke apart during the implantation of the hydrophilic IOL. These IOLs are provided with the disposable injector and the cartridge packed along with the IOL or separately. The leading haptic and optic went inside the capsular bag but the cartridge shaft broke away vertically parallel to the axis of the cartridge 6-8mm from the tip as the trailing haptic passed through the weak area [Figs. 1 and 2]. The folding of the IOL was done by the author himself under the operating microscope. Another injector and the cartridge were used for the implantation of the IOL.
The mishap did not affect the postoperative visual out come, as the IOL was withdrawn from the anterior chamber but left us in doubt about the manufacturing defect. The matter was reported to the concerned manufacturer and requested to provide an extra injector and the cartridge.
I do agree with the authors about inspection of cartridge under the slit lamp/microscope for the damage so as to replace immediately. But weak areas on the cartridge may be missed sometimes. Such occurrences could be routine but few are reported. India being a huge market for the disposables used for cataract surgery quality control is essential. I take this opportunity to request All India Ophthalmological Society to form a quality control committee which will ensure uniform quality of the disposables used in the ocular surgery.
© 2013 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow
1. Biswas P, Sengupta S, Paul A, Kochgaway L, Biswas S. Descemet's tear due to injector cartridge tip deformity Indian J Ophthalmol. 2012;60:218–20