{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:15:35Z","timestamp":1778073335187,"version":"3.51.4"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Fakult\u00e4t Heidelberg der Universit\u00e4t Heidelberg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This experimental study aimed to guide cataract surgeons in selecting suitable intraocular lens (IOL) injectors by evaluating the in vitro resistance force during IOL ejection and assessing associated injector damage across modern injector models. Twenty-five injectors from five manufacturers were tested using\u2009+\u200920 diopter lenses. IOLs were ejected into petri dishes, and resistance forces were continuously recorded with an automated digital force gauge. Parameters including maximum force and the area under the curve (AUC) were analyzed. After each ejection, injector nozzle tips were examined microscopically and graded for damage using the HeiScore. Significant differences in resistance forces were found among injector models (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), with maximum forces ranging from 4.39\u2009\u00b1\u20090.45\u00a0N to 25.71\u2009\u00b1\u20096.62\u00a0N. The AUC also showed significant variability, indicating differing levels of force required for IOL delivery. No ejection complications occurred, though one injector model exhibited markedly higher nozzle damage compared to others. These findings demonstrate substantial variability in resistance and durability among modern IOL injectors and underscore the importance of understanding these differences to ensure safe, controlled, and efficient IOL implantation in cataract surgery.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-41145-7","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:38:37Z","timestamp":1778071117000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variation in resistance force during intraocular lenses injection by modern injectors and assessment of damage to the injector: a laboratory analysis"],"prefix":"10.1038","volume":"16","author":[{"given":"Maximilian","family":"Friedrich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor A.","family":"Augustin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald J.","family":"Munro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Hammer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Schickhardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyeck-Soo","family":"Son","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd U.","family":"Auffarth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"41145_CR1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.4274\/tjo.52386","volume":"46","author":"M Tetiko\u011flu","year":"2016","unstructured":"Tetiko\u011flu, M. et al. Effect of corneal incision enlargement on surgically induced astigmatism in biaxial microincision cataract surgery. Turk. J. Ophthalmol. 46, 99\u2013103. https:\/\/doi.org\/10.4274\/tjo.52386 (2016).","journal-title":"Turk. J. Ophthalmol."},{"key":"41145_CR2","doi-asserted-by":"publisher","first-page":"2659","DOI":"10.1038\/s41598-023-29497-w","volume":"13","author":"M Friedrich","year":"2023","unstructured":"Friedrich, M., Auffarth, G. U. & Merz, P. R. Experimental analysis of recommended corneal incision sizes in cataract surgery using 13 intraocular lens injector systems. Sci. Rep. 13, 2659. https:\/\/doi.org\/10.1038\/s41598-023-29497-w (2023).","journal-title":"Sci. Rep."},{"key":"41145_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.xops.2023.100356","author":"M Friedrich","year":"2023","unstructured":"Friedrich, M. et al. Laboratory analysis of causative factors for the final incision size due to intraocular lens injector insertion. Ophthalmol. Sci. https:\/\/doi.org\/10.1016\/j.xops.2023.100356 (2023).","journal-title":"Ophthalmol. Sci."},{"key":"41145_CR4","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1055\/a-2349-2158","volume":"241","author":"M Friedrich","year":"2024","unstructured":"Friedrich, M., Munro, D. J., Auffarth, G. U. & Khoramnia, R. Characterisation of intraocular lens injectors. Klin. Monatsbl. Augenheilkd. 241, 905\u2013916. https:\/\/doi.org\/10.1055\/a-2349-2158 (2024).","journal-title":"Klin. Monatsbl. Augenheilkd."},{"key":"41145_CR5","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1016\/j.jcrs.2015.03.018","volume":"41","author":"M Usui","year":"2015","unstructured":"Usui, M. & Tanaka, T. Resistance force for intraocular lens insertion through lens cartridges and syringe-type injectors. J. Cataract Refract. Surg. 41, 1745\u20131751. https:\/\/doi.org\/10.1016\/j.jcrs.2015.03.018 (2015).","journal-title":"J. Cataract Refract. Surg."},{"key":"41145_CR6","doi-asserted-by":"publisher","first-page":"2723","DOI":"10.1038\/s41598-022-06696-5","volume":"12","author":"H Fang","year":"2022","unstructured":"Fang, H. et al. A laboratory evaluation of nozzle tip damage in four generations of intraocular lens injector systems using a self-developed damage scale. Sci. Rep. 12, 2723. https:\/\/doi.org\/10.1038\/s41598-022-06696-5 (2022).","journal-title":"Sci. Rep."},{"key":"41145_CR7","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1159\/000531078","volume":"66","author":"L Zhang","year":"2023","unstructured":"Zhang, L., Auffarth, G., Schickhardt, S., Merz, P. & Tandogan, T. Evaluation of nozzle tip damage in intraocular lens injectors with V-shaped notch. Ophthalmic Res. 66, 1104\u20131113. https:\/\/doi.org\/10.1159\/000531078 (2023).","journal-title":"Ophthalmic Res."},{"key":"41145_CR8","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1177\/11206721231204382","volume":"34","author":"ID Baur","year":"2024","unstructured":"Baur, I. D. et al. In vivo comparison of implantation behavior and laboratory analysis of two preloaded intraocular lens injectors. Eur. J. Ophthalmol. 34, 766\u2013773. https:\/\/doi.org\/10.1177\/11206721231204382 (2024).","journal-title":"Eur. J. Ophthalmol."},{"key":"41145_CR9","doi-asserted-by":"publisher","unstructured":"Zhang, L., Schickhardt, S., Merz, P. & Auffarth, G. U. Evaluation of parameters and nozzle tip damage after clinical use of three hydrophilic intraocular lens injector models. J. Ophthalmol. 2024, 2360368. https:\/\/doi.org\/10.1155\/2024\/2360368 (2024).","DOI":"10.1155\/2024\/2360368"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41145-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41145-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41145-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:38:38Z","timestamp":1778071118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41145-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["41145"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-41145-7","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]},"assertion":[{"value":"14 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"G.U. Auffarth reports lecture fees and research grants from Johnson & Johnson Vision, Alcon Laboratories, Carl Zeiss Meditec AG, Hoya Corp., Kowa Co., Ltd., Oculentis GmbH\/Teleon, Physiol S.A., and Rayner Intraocular Lenses Ltd.; nonfinancial support from Contamac, Cristalens, EyeYon, and Hanita outside the submitted work.V. A. Augustin reports research grants from Kowa Co. and travel grants from Roche Holding AG outside the submitted work.For the remaining authors none were declared.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Ethics committee approval was not required for this laboratory study due to the non-human ex vivo nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"14415"}}