Prospective Study Of Small Aperture Iol Implantation In Eyes With Previous Refractive Procedures

To assess the visual outcomes in cataract patients treated with contralateral implantation of a small aperture IC-8 intraocular lens (IOL) in eyes with a history of either corneal inlay or laser refractive surgery.

Asian Eye Institute, Makati City, Philippines

Prospective, single-site study of 29 cataract patients with prior corneal refractive surgery. Sixteen subjects had a history of keratorefractive surgery (post refractive group RG), and 13 subjects were previously treated with a corneal inlay (post inlay group IG) which were removed. Both groups were treated in one eye with an IC-8 IOL, with a refractive target of -0.75 D.  Fellow eyes in the post refractive group received a monofocal or monofocal toric IOL with a plano target. Fellow eyes in the post inlay group did not undergo cataract surgery. Monocular and binocular uncorrected (U) distance (D), intermediate (I) and near (N) visual acuity (VA), depth of focus, and visual symptoms were assessed at 12 months.

For the RG, the mean logMAR ± SD monocular UCDVA, UCIVA, and UCNVA in IC-8 eyes at 12 Months was 0.05 ± 0.06 (20/22), 0.04 ± 0.14 (20/22), and 0.09 ± 0.13 (20/25), and binocular UCDVA, UCIVA, and UCNVA was 0.02 ± 0.05 (20/21), 0.02  ± 0.11 (20/21) and 0.078 ± 0.12 (20/24). For the IG, the mean logMAR ± SD monocular UCDVA, UCIVA, and UCNVA in IC-8 eyes at 12 Months was 0.10 ± 0.09 (20/25), 0.05 ±0.08 (20/22), and 0.05 ± 0.09 (20/22), and binocular UCDVA, UCIVA, and UCNVA was 0.06 ± 0.09 (20/23), 0.05 ± 0.08 (20/22), and 0.05 ± 0.09 (20/22). Defocus curve testing yielded 2.32 D and 2.33 D depth of focus in the RG and IG, respectively. Visual symptoms were low for most symptoms in severity and bothersomeness.

These results demonstrate that the small aperture IOL provides good distance, intermediate and near visual acuity for cataract patients with a history of prior corneal refractive surgery.