Acufocus Ic-8 Implantation During Cataract Surgery In Irregular Corneas

Acufocus-IC8 is a 6 mm single piece hydrophobic acrylic pinhole implant with a functional range of 3 D, implanted bilaterally or in the non-dominant eye of a patient with irregular corneas and no retinal pathology.

The aim of this study is to improve the visual and refractive outcome of highly aberrated and irregular corneas following cataract surgery and IC8 implantation.

The study is conducted at Hubert Vision private practice, 26 Rue de la Porte Neuve, 6700 Arlon, Belgium, all patients with cataract and irregular corneas, have been operated in the private theater facility by Dr Cristina Hubert, in topical anesthesia.

Materiel et method: This is a prospective single site, single surgeon study.  So far, 5 patients (2 females and 3 males with a total of 8 eyes) with cataract and irregular corneas were implanted with Acufocus at Hubert Vision private practice, 3 patients bilaterally and 2 patients unilaterally. The corneal pathology associated with the implantation was keratoconus in 2 eyes, basal membrane dystrophy in one eye, and radial keratotomy in 5 eyes. Mean age was 67.5. The IOL formula calculation used was Barret and Sirius topographic IOL calculation module. The target refraction was -0.75.

The UCVA and BCVA improved in all patients at all distances. In the most advance case, BCVA improved from light perception to 1/10, and from counting fingers to 10/10 in the advanced keratoconus. All other eyes achieved 10/10, 2 with glasses, and significant reduction in glare and dysphotopsia. There were no intraoperative or postoperative complications, one patient had higher IOP well controlled with treatment. One patient developed secondary cataract and was treated with YAG capsulotomy 4 months after the surgery. Binocular implantation is rare, normally it's implanted in the non-dominant eye. The only downside is the bigger 3.5 mm incision, which in the case of advance keratoconus and 8 incision RK needed a suture at the end of surgery.

Conclusion: IC8 provides good quality of vision at all distances, but some of the patients still needed glasses in our case series. There was no need for toric IOL correction, as with the IC8 the increased depth of focus is up to 3D of astigmatism. Acufocus IC8 is safe and effective, in monocular or binocular implantation for eyes with irregular corneas without disturbing the visualization of the retina or interfering with the performance of the visual field or other tests. It improves the quality of vision and the quality of patients’ life.