1. Implantation of a single-piece acrylic intraocular lens using an anterior chamber maintainer Tomoyuki Kunishige, Hisaharu Suzuki, Toshihiko Shiwa, Hiroshi Takahashi Authors have no finacial interest. Nippon Medical School

2. Backgrounds The ophthalmic viscosurgical devices (OVDs) are now thought to be essential for safe phacoemulsification. However, there are at least 2 concerns regarding OVD use. The first is the intraocular presssure (IOP) elevation after the surgery if the OVD is left in the anterior chamber. The second is the cost of the material because the OVDs are still expensive. If the technique of implanting intraocular lens (IOL) without using OVD is available, it might be helpful to solve these problems.

3. Purpose To examine a technique for implantation of a single-piece acrylic IOL using an anterior chamber maintainer instead of OVD.

4. Methods ・ Methods: Male : Female ＝ 3 : 3 (6 eyes) Mean age ： 76 years After phacoemulsification was performed through a 2.8-mm superior sclerocorneal incision, an anterior chamber maintainer was inserted into the side port at 3 o'clock. The NY-60 IOL was loaded with balanced salt solution (BSS) in the cartridge. While maintaining the anterior chamber depth and the capsular bag by continuous BSS irrigation, the IOL was inserted. All surgeries were performed by a single surgeon. ・ Subjects ：

5. NY-60 （ iMics 1 ® ） HOYA Injector System NY-60 single-piece acrylic IOL Type-N18 cartridge Setting the IOL in the cartridge with BSS

6. The detail of the procedure Insert the anterior chamber maintainer Fill the cartridge with BSS Implant the IOL The IOL in the capsular bag

7. Results In all cases, the IOL was smoothly inserted into the capsular bag without causing the collapse of the anterior chamber or the capsular bag. No serious intraoperative or postoperative complications were observed.

8. Discussion By using an anterior chamber maintainer, IOL can be inserted safely without using OVD. Also a new IOL cartridge system eliminate the OVD use for IOL setting. Taken together, this method can reduce the risk of the IOP elevation, and lessen the cost of OVD. One important point is that the IOL should be inserted carefully with checking the stability of the anterior chamber depth.

9. Implantation of a single-piece acrylic intraocular lens using an bimanual Irrigation aspiration. Harshul Tak, J Cataract Refract Surg, 2010 Shimizu, J Cataract Refract Surg, 2008 The technique of IOL implantation into the capsular bag without OVD has been reported. Implantation of a 3-piece silicone intraocular lens using an KS-VF disposable injector. The results of the present study agree with these reports.

10. Conclusion Using an anterior chamber maintainer, it is possible to implant a single-piece acrylic IOL into the capsular bag safely without using OVD.