Protecting the haptic when a Monarch injector is used
Tsuneoka and coauthors'1 summary of their experience using the AcrySof intraocular lens (IOL) with a Monarch injector is well written and of great relevance. We, too, have found this to be a useful technique and wanted to share a point that may not have been stressed enough in this article.
When placing the 6.5 mm MA50 IOL into the Monarch injector, it is important to ensure that the trailing haptic is out of the way of the plunger. The Monarch II B cartridge has a peg, which allows the surgeon to set the trailing haptic off to the side (Figure 1). This allows the plunger to go forward, pushing the optic and avoiding the haptic. As the IOL goes into the cartridge, the haptic will flip and go over the plunger, allowing safe delivery into the eye. If the haptic is not put to the side and protected in this manner, the haptic will be damaged by the plunger, something that occurred at our institution in the past.
Thomas A. Oetting MD, MS
Hilary A. Beaver MD
Iowa City, Iowa, USA
© 2005 by Lippincott Williams & Wilkins, Inc.
1. Tsuneoka H, Hayama A, Takahama M, Takashina H. 6.5 mm optic AcrySof implantation through a 3.0 mm incision. J Cataract Refract Surg 2003; 29:1869-1973