Tooling up for glued IOLs: Significance of three-piece IOLs and injectors

IOLs and their respective materials and designs are intended to be inert and made in a way so that they are easy to handle concerning the folding-unfolding aspect and implantation into the eye. The importance of the overall length of an IOL for intrascleral haptic fixation cannot be understated. Along with the length of the IOL, the shape, configuration and material of the haptics are equally important. The smoothness with which the IOL unfolds and presents itself in the eye is also crucial. The type of IOL used and the kind of injector employed for unfolding the IOL intraocularly are of equal concern.A three-piece IOL is preferred and recommended for glued intrascleral haptic fixation. The main issue with a one-piece IOL is the difficulty incurred in externalizing the haptics because the haptics are not flexible and tend to break easily. A foldable or non-foldable three-piece IOL can be easily employed in the glued IOL technique; the disadvantage with the non-foldable three-piece IOL is that a larger incision is required to introduce the IOL as compared with the foldable counterpart, but the non-foldable IOL has fewer chances of optic capture because it has an optic diameter of 6.5 mm as compared with a foldable IOL that has a 6-mm optic.