Structural integrity of intraocular lenses with eyelets in a model of transscleral fixation with the Gore-Tex suture

Purpose:To compare fracture characteristics of intraocular lenses (IOLs) used in transscleral fixation with the Gore-Tex suture.Setting:Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.Design:Experimental study.Methods:A model was designed to compare the eyelet fracture characteristics of enVista MX60 IOL (model available before June 2018), the enVista MX60E IOL (current model), the Akreos AO60 IOL, and the CZ70BD IOL. Tension was applied through the Gore-Tex suture and measured with a digital force gauge. Two suture configurations (radial and nonradial) were tested using the MX60E IOL.Results:A total of 25 trials were conducted. The mean eyelet fracture force was 1.666 newtons (N) for the MX60 IOL (range, 1.000-2.000), 1.000 N for the MX60E IOL (range, 1.000-1.000), 2.330 N for the AO60 IOL (range, 2.000-3.000), and 0.998 N for the CZ70BD IOL (range, 0.990-1.000). When compared with the MX60E IOL, a greater eyelet strength was observed with the MX60 (P =.024) and AO60 (P =.004) IOLs. Radial and nonradial suture configurations did not affect the MX60E eyelet fracture force.Conclusions:The enVista MX60E eyelet may be less resistant to Gore-Tex suture tear out compared with the MX60 and AO60 IOLs. Altering suture configuration did not affect enVista eyelet resistance to fracture. During off-label use in transscleral fixation, extra caution should be taken when handling IOLs and applying tension on sutures.