I read with interest the letter by Vrabec et al1 about forceps-induced scratching of a foldable acrylic intraocular lens. I have had several such instances myself and, although they do not seem to affect vision, they are undesirable. On reviewing the videotape, I believe all of my cases have been caused by the.12 forceps. These were used to hold the anterior edge of the wound, scratching the foldable lens as it was inserted.
I have since modified my technique and either start the lens in the incision without holding the edge with forceps or if necessary hold the edge of the wound with the forceps only to get the lens started, then insert the forceps through the side port to stabilize the eye while the lens is inserted. I use a 3.75-mm incision for the 6.0-mm acrylic lens, and this does at times require a fair amount of squeezing.
Fry LL. Another Possible Cause of Forceps-Induced Scratching of a Foldable Acrylic Intraocular Lens. Arch Ophthalmol. 1997;115(6):823. doi:10.1001/archopht.1997.01100150825033