Centration And Stability Of Small-Aperture Intraocular Lens In Aberrated Eyes

To investigate the visual outcomes and postoperative stability of IC-8 intraocular lens (AcuFocus, Inc) implantation following femtosecond laser–assisted cataract surgery.

The IC-8 IOL was implanted in the non-dominant eye of 12 patients who underwent femtosecond laser assiated cataract surgery (FLACS). FLACS was performed using the LDV Z8 laser platform (Ziemer).  Centration and uncorrected and corrected distance, intermediate, and near visual acuities (UDVA, UIVA, UNVA, CDVA, CIVA, CNVA) were evaluated.

To evaluate centration, intraoperative photographs were obtained from surgical videos taken intraoperatively. Postoperative external eye photographs were obtained using a slit-lamp camera, following pharmacological mydriasis. Intraoperative and postoperative centration was evaluated using Photoshop 2018 CC (Adobe, Inc) in relation to two reference points: the center of the capsulorhexis and the limbus.

There were no significant differences in absolute, vertical, and horizontal centration postoperatively versus intraoperatively. From intraoperative to POM3, mean displacement was 0.17±0.09 and 0.14±0.07 mm (p=0.52) relative to the capsulorhexis and 0.28±0.22 and 0.25±0.14 mm relative to the limbus (p=0.62), respectively. Centration remained within the 1.36 mm IC-8 aperture.

UDVA improved significantly from 0.52±0.39 to 0.20±0.11 logMAR (p=0.024) at 3 months; efficacy index=0.80±0.31. Safety index was 1.30±0.40, with no adverse events. At POM3, CDVA, UIVA, and UNVA of 0.04±0.05, 0.27±0.11, and 0.22±0.10 logMAR were achieved, respectively. Binocularly, all achieved UDVA of 20/25 or better and UIVA and UNVA of N6 and better.

The IC-8 IOL can attain good centration and positional stability up to POM3. It enables both extended depth of focus and tolerance to aberration, making it capable of achieving spectacle independence after surgery.