Phacoemulsification With Implantation Of A Small-Aperture Intraocular Lens In Eyes With Irregular Astigmatism After Radial Keratotomy
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT351 | Type: Poster | DOI: 10.82333/pkyv-at73
Authors: Prof. Dr Ugo De Sanctis* 1 , Dr Paolo Caselgrandi 2 , Dr Elion Aliu 2 , Dr Cecilia Tosi 3
1Department of Surgical Sciences, University of Turin,Eye Clinic, City of Health and Science Hospital,Turin,Italy;De Sanctis Eye Clinic,Turin,Italy, 2Department of Surgical Sciences, University of Turin,Eye Clinic, City of Health and Science Hospital,Turin,Italy, 3De Sanctis Eye Clinic,Turin,Italy
Purpose
Small-aperture intraocular lenses (IOLs) use the pinhole effect to block unfocused peripheral light rays. They provide an extended depth of focus and improve image quality by reducing retinal blur. This type of IOL is particularly suitable for reducing the impact of higher-order aberrations (HOAs) in eyes with irregular corneas and cataract. This study reports the visual and refractive outcomes after cataract surgery with implantation of the IC-8 (Bausch & Lomb) small-aperture IOL in eyes with irregular corneal astigmatism caused by radial keratotomy (RK).
Setting
Private practice.
Methods
This retrospective study included one eye of 7 consecutive patients (mean age 68.6 years) with irregular astigmatism after RK and cataract who underwent phacoemulsification and IC-8 implantation at a single center. Mean corneal astigmatism was 1.41 ±0.44 diopters (D). The mean root mean square of HOAs, estimated at the corneal plane for the mesopic pupil, was 1.982 ±1.081 µm. IOL power was calculated using the IOLMaster 700 (Carl Zeiss Meditec) and the Barrett True-K formula. The target postoperative spherical equivalent (SEQ) ranged from −0.66 to −1.38 D. Outcome measures included postoperative recovery of distance and near visul acuity and SEQ prediction error at 3 months postoperatively.
Results
Postoperatively, uncorrected distance visual acuity (UDVA) and corrected distance vsual acuity (CDVA) improved in all eyes. Mean UDVA improved from 1.01 to 0.30 LogMAR, and mean CDVA improved from 0.40 to 0.11 LogMAR. UDVA ≤ 0.3 and CDVA ≤ 0.1 were achieved in 5 of 7 eyes. Mean postoperative distance-corrected near visual acuity was 0.24 LogMAR. A hyperopic SEQ prediction error was observed in all eyes. Mean prediction error was +0.52 ± 0.30 D (mean postoperative SEQ −0.39 ± 0.30 D vs mean predicted SEQ −0.91 ± 0.23 D). No major complications were observed.
Conclusions
The IC-8 small-aperture IOL performed well in eyes with irregular astigmatism after RK, providing significant improvement in visual function and high patient satisfaction. When using the Barrett True-K formula for IOL power calculation in these eyes, a hyperopic prediction error should be anticipated.