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Résultats fonctionnels après implantation d'un implant intra-oculaire à très petite ouverture chez deux patients ayant un astigmatisme irrégulier après une chirurgie réfractive

The small-aperture IOL (IC-8; AcuFocus, Irvine, CA) is a hydrophobic acrylic lens with an UV filter and a central pinhole aperture from 1.36mm. The purpose of this study was to describe the use of an IOL IC-8 in 2 patients with irregular astigmatism resulting from previous refractive surgery. 

Both patients presented with cataracts, one patient previously had a radial keratectomy in 1990 and the other patient had a hyperopic photorefractive keratectomy in 2008, both resulting in irregular astigmatism that could not be fully compensated with glasses. The first patient had a best corrected visual acuity of 0.20 LogMar in the right eye and 0.10 LogMar in left eye. The second patient had a best corrected visual acuity of 0.10 LogMar in each eye. Both complained of blurred visual quality. Standard cataract surgery was performed in both cases. For the first patient, the IOL IC-8 was implanted into the patient’s non-dominant eye and a clear aspheric monofocal lens was implanted into the dominant eye. For the second patient, an IOL IC-8 was implanted in both eyes. We assessed the visual performances 6 months after the surgery including measurements of uncorrected and best corrected distance visual acuity and uncorrected and best distance-corrected near visual acuity. Additionally, a visual field examination was conducted.

The first patient achieved a best corrected visual acuity of 0.2 LogMar in the right eye and 0.1 LogMar in the left eye postoperatively. The second patient achieved a best corrected visual acuity of 0.0 LogMar in both eyes postoperatively. Both patients were satisfied with the outcome although their visual field was slightly restricted in the superior area in the 90° perimetry, but clear in the 30° perimetry.

There are many options available nowadays to correct an irregular astigmatism.  For patients undergoing a cataract surgery, a small-aperture intraocular lens (IC-8) can be an ideal alternative to a hard contact lens, which is not always tolerated, or to another refractive surgery with uncertain outcome.

The small-aperture intraocular lens (IC-8) is a good solution to be implanted either bilaterally or solely in the non-dominant eye for patients with irregular astigmatism after refractive surgery.