Eyeworld

83 EW REFRACTIVE March 2019 Editors' note: Dr. Dick has financial interests with AcuFocus. Contact information Dick: burkhard.dick@kk-bochum.de Dr. Dick noted that for highly aberrated eyes, the XtraFocus 93L implant (Morcher, Stuttgart, Ger- many) with a pinhole diameter of 1.3 mm and a total disc diameter of 6 mm provided a total mask and stable sulcus implantation that was preferable for more extreme cases. When imaging the retina in eyes with the IC-8 IOL, narrow-angle mode of 30 to 45 degrees works best to provide good quality images. Dr. Dick uses fundus photography and angiography, dilating the pupil for best results. "Especially interesting is the use of the IC-8 IOL as a therapeutic device. … I think this device has great potential in the area of corneal pathologies including irregularities, aberrations, post-refractive surgery, and iris/pupil pathologies. Retinal visualization surgery is possible with minimal adjustment," he said. Patient choice Dr. Dick described an uncomplicat- ed set of inclusion criteria for IC-8 IOL implantation. "When I counsel patients, I look for corneal astigma- tism at or below 1.5 D. There are no handling issues with this lens and no logistics. There is no need for marking the cornea or for intraop- erative calculations, intraoperative changes, or the consideration of rotational aspects, compared to toric IOLs. I personally do not address any photic phenomena with pa- tients, like glare or halo, or consider the need for secondary procedures, which I always do if I implant EDOF or multifocal lenses. What I do tell patients, however, is that they may experience a period of adaptation when moving from light to dark rooms, especially in the first weeks to months after surgery," he said. Bilateral small aperture implantation In a patient subset, satisfaction with the results of monocular IC-8 IOL implantation in the first eye prompt- ed the desire for a small aperture im- plant in the second eye as well. Dr. Dick's 6-month results with bilateral IC-8 implants revealed no negative effect on distance, intermediate, or near visual acuity, compared to the monocular outcomes, but seemed to further increase the extended depth of focus. "Visual acuity in these patients was even better," he noted. "Patients do not complain of any visual disturbances. There are new technologies being developed in this direction, so I think it is worthwhile to look at them," he said. EW Reference 1. Dick HB, et al. Prospective multicenter trial of a small-aperture intraocular lens in cataract surgery. J Cataract Refract Surg. 2017;43:956–968. COMING SOON Experience the new EyeWorld Studio WATCH US AT EYEWORLDLIVE.COM Beginning at the 2019 ASCRS•ASOA Annual Meeting San Diego May 3–7, 2019 ASCRS LIVE

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