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IC-8 small aperture intraocular lens combined with Sulcoflex supplementary IOL treatment of cataract in a patient with previous radial keratotomy: case report

Poster Details

First Author: V.Barnett UK

Co Author(s):    H. Sandhu   J. Than   A. Barsam              

Abstract Details


Patients who have undergone previous radial keratotomy pose a particular challenge in terms of accurate prediction of refractive outcome post-cataract surgery, due to inaccurate assumptions of effective lens position and total corneal power using traditional IOL power calculation formulae in these cases. Additionally, such patients may place additional value on spectacle independence and hence demand good uncorrected distance, intermediate and near visual acuities post-operatively. We present a case in whom excellent refractive outcome and spectacle independence at distance, intermediate and near was achieved post-cataract surgery via implantation of IC-8 small aperture intraocular lens, refraction, and subsequent Sulcoflex Supplementary IOL insertion.


Ophthalmology Department, Luton and Dunstable University Hospital, United Kingdom


A 73 year old patient with previous radial keratotomy and cataract was recruited. Biometry was performed. It was decided to implant an IC-8 small aperture intraocular lens (AcuFocus Inc., CA, USA) in light of ocular co-morbidity and patient preference. Subsequent Sulcoflex Supplementary IOL (Rayner Intraocular Lenses Ltd., UK) implantation was also planned in light of likely suboptimal refractive outcome, and also due to biometry prediction of required IOL power exceeding the maximum available IC-8 power of 27.5 dioptres. IC-8 IOL implantation, subsequent refraction and Sulcoflex Supplementary IOL implantation were performed uneventfully. BCVA and refraction were recorded pre- and post-operatively.


BCVA improved from logMAR equivalent 0.18 at baseline to -0.14 post-operatively. Refraction was �.375D spherical equivalent at baseline and improved to -0.5D post-operatively. The patient was delighted with post-operative outcome. No complications were noted.


Our case study demonstrates that IC-8 small aperture IOL implantation with subsequent refraction and Sulcoflex Supplementary IOL implantation represents a safe and effective approach to cataract surgery in patients with previous radial keratotomy. A larger study with increased sample size and comparison to traditional IOL implantation is required to provide further evidence of the benefits of this approach.

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