Implantation Of A Small Aperture Ic-8 Extended-Depth-Of-Focus Intraocular Lens In Cataract Surgery In Post-Rk Patients, Three Clinical Cases.

Published 2024 - 42nd Congress of the ESCRS

Reference: PP19.11 | Type: Free paper | DOI: 10.82333/htt0-9s03

Authors: Clara Bonel Pla* ¹ , Miriam Barbany ¹ , Ruben Delgado ¹ , Anton Barraquer Kargacin ¹ , Jose Lamarca ¹ , Victor Charoenrook ¹ , Rafael I. Barraquer Compte ¹

¹Centro Oftalmologia Barraquer,Barcelona,Spain

Purpose

Cataracts are one of the main causes of visual impairment globally and cataract surgery is a well-established procedure for restoring vision. However, there are situations that influence cataract surgery success, such as radial keratotomy (RK). Unpredictable IOL Power Calculation due to altered corneal shape, persistent astigmatism potentially impacting vision quality and the fluctuating vision further complicating outcome assessment. We present three clinical cases that aim to investigate the potential benefits of using the IC-8 IOL in cataract surgery for patients with a history of RK and to determine if this lens offers a viable solution for improving vision and reducing dependence on glasses in this specific patient population.

Setting

This case series explores the use of the IC-8 intraocular lens (IOL) in cataract surgery for two patients with previous history of radial keratotomy. The first patient underwent unilateral implantation and the second patient bilateral implantation of IC-8 IOL. All procedures were performed at the Barraquer Ophthalmology Center in Barcelona, Spain.

We present three eyes who underwent cataract surgery and IC-8 lens implantation.

Methods

Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 80 cm and uncorrected near visual acuity (UNVA) at 40 cm were measured at the 3-month follow-up visit. Adverse events, spectacle independence, visual symptoms and patient satisfaction were also assessed at final follow-up.

The first patient had a RK (8 cuts) only in her right eye (RE) and suffered from fluctuating and UDVA of 0.07 in that eye. We did cataract surgery with a monofocal IOL implantation on the LE with a good refractive outcome. Then performed cataract surgery on the RE and a IC-8 IOL implantation. In the second case the binocular UDVA was 0.3 and she also suffered from fluctuating vision. The same surgery was performed in both eyes.

Results

The results, on the first case, three months later was an UDVA of 0.75, UIVA of 1.0 and UNVA 0.8 (decimal scale) in her right eye. Binocular UDVA, UIVA and UNVA was 1.0.

In the second case, the final binocular UDVA at 2 months was 1.0, UIVA was 1.0 and UNVA was 0.64.

Both patients were given a questionnaire 3 months after surgery (scored on a 10-point scale) on the following items: overall satisfaction, which was 10/10 in both patients; spectacle independence, which was 9/10 in the first patient and 10/10 in the second case; improvement in symptoms such as dysphotopsias/halos/glare, which was 10/10 in both cases; and night vision, which was 9/10 in both questionnaires. No adverse events were reported.

Conclusions

These results suggest that the IC-8 IOL may offer a promising approach for post-RK cataract surgery. In our case, both patients experienced a significant improvement in binocular UDVA, UIVA and UNVA. IC-8 IOL implantation also seems to decrease photic phenomena, decreases spectacle dependence and provides a high overall satisfaction. Further research with larger patient cohorts is warranted to definitively establish the long-term safety and efficacy of this approach in this particular population.