Visual And Refractive Outcomes Of A Small Aperture Intraocular Lens In Keratoconic Eyes After Cataract Surgery
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT570 | Type: Free paper | DOI: 10.82333/rtex-6p40
Authors: Dr Daniel Schartmüller* 1 , A/Prof. Gerald Schmidinger 1 , Dr Victor Danzinger 1 , Dr Nikolaus Mahnert 1 , Dr Marcus Lisy 1 , A/Prof. Claudette Abela-Formanek 1 , Dr Markus Schranz 1 , A/Prof. Christina Leydolt 1
1Ophthalmology and Optometry,Medical University of Vienna,Vienna,Austria
Purpose
To evaluate visual and refractive outcomes in patients with cataract and keratoconus after implantation of a small aperture intraocular lens (IOL).
Setting
Prospective, single center, clinical study at the Medical University of Vienna
Methods
In this prospective, clinical study, 9 eyes of 9 patients with age related cataract and keratoconus of at least stadium 2 in the Belin ABCD classification were included. All patients received a small aperture IC-8 IOL (Bausch & Lomb, Rochester, NY). Two to three months after surgery, postoperative follow-up visits have been conducted. Subjective refraction, monocular BCDVA at 4m, DCIVA at 80cm and DCNVA at 40cm tests using EDTRS charts have been performed. Defocus curves ranging from +0.50 to -2.50 diopters have been performed. Decentration and tilt of the IOL was measured using an AS-OCT Casia 2 (Tomey Coorp, Nagoya, Japan). Subjective PROMs were performed using the VF-7 questionnaire.
Results
Mean spherical equivalent after surgery was -0.7±1.2 diopters. Mean refractive cylinder after surgery was -1.8±1.8 diopters. Best corrected distance visual acuity was 0.1±0.08 logMar, DCIVA was 0.14±0.11 logMar, DCNVA was 0.24±0.15 logMar. Defocus curve values ranged from 0.19±0.14 logMar (+0.5D) to 0.33±0.17 logMar (-2.5D). Decentration and tilt values were 0.32±0.16mm and 5.05°±1.1°, respectively.
Conclusions
Implantation of the IC-8 IOL showed very good results regarding far and intermediate vision in highly aberrated corneas with keratoconus. Decentration and tilt values were comparable to other IOLs. Defocus curves showed a long plateau phase from +0.5 diopters to -2.0 diopters. Implanting a small aperture IOL to reduce higher order aberrations after cataract surgery should be considered in eyes with moderate to severe keratoconus.