Eyeworld

JUNE/JULY 2020 | EYEWORLD | 29 C experience with the lens led to "several justifica- tions … to explore bilateral implantation." "Unlike the inlay, which was implanted in the cornea, the IC-8 is implanted behind the pupil and is closer to the nodal point. This allows it to function like the new pupil," he said. "If the results are very good and patients are satisfied with IC-8 in one eye, there had to be scientific data to answer the question why the lens cannot be implanted in the fellow eye as well. Most patients with corneal irregularities or high aberrations have this problem in both eyes." Dr. Ang went on to say that the hesitation in implanting the IC-8 bilaterally stems from the presumption that small aperture optics in both eyes will significantly decrease contrast, constrict the visual field, and affect nighttime vision. "In accepting only patients who request second eye implantation, we have selected patients who are not symptomatic of these problems and improve the chance of achieving high patient satisfaction after bilateral implanta- tion," he said. Contact Ang: angbobby@hotmail.com We think patients can only decide after they have seen the visual outcome of the first eye," he said. "Patients who are not satisfied after first eye implantation of IC-8 should not be advised to have the second eye implanted with the same IC-8." A previous study published in 2018 com- pared clinical outcomes of IC-8 implanted in one eye vs. bilaterally. 2 This study, in contrast to Dr. Ang's results, found better intermediate and near vision in the single eye IC-8 group. "This difference may be attributed to a dif- ference in enrollment criteria. In our study, only patients who voluntarily expressed their desire to have the IC-8 IOL in their second eye after their first eye was treated were enrolled into the study," Dr. Ang wrote in his study. "Addition- ally, if the patient reported dissatisfaction with the range of vision in the first treated eye, the target refraction could be adjusted for the sec- ond eye to compensate for that dissatisfaction." Dr. Ang told EyeWorld that while monolat- eral implantation of IC-8 is the standard of care in countries where the lens is available, ongoing References 1. Ang RE. Visual performance of a small-aperture intraocular lens: first comparison of results after contralateral and bilateral implantation. J Refract Surg. 2020;36:12–19. 2. Dick HB, et al. Binocular and monocular implantation of small-aperture intraocular lenses in cataract surgery. J Refract Surg. 2018;34:629–631. Relevant disclosures Ang: AcuFocus Dilated eye with IC-8 Source (all): Robert Ang, MD IC-8 for corneal irregularities While perhaps originally created as a presbyopia-correcting IOL, others are finding utility in IC-8 addressing corneal irregularities. A prospective study pub- lished earlier this year described IC-8 in 17 patients with non-progressive kerato- conus, previous penetrating keratoplas- ty, post-RK, or ocular trauma scarring. Corrected distance visual acuity and uncorrected visual acuity at distance, intermediate, and near improved in all patients postop. Scores on a quality of life assessment also improved. Reference Shajari M, et al. Safety and efficacy of a small-aperture capsular bag-fixated intraocular lens in eyes with severe corneal irregularities. J Cataract Refract Surg. 2020;46:188–192.

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