Bilateral implantation of small-aperture IOLs can be a successful strategy for presbyopia correction, according to a study.
To compare visual acuity after contralateral vs. bilateral implantation of the IC-8 IOL (AcuFocus) in cataract patients, Robert E. Ang, MD, of Asian Eye Institute, Philippines, implanted 10 patients bilaterally with the IC-8 and 10 patients monolaterally with the IC-8 in one eye and a monofocal IOL in the other.
At 12 months postoperatively, all 20 patients achieved 20/32 or better binocular uncorrected distance visual acuity and corrected distance visual acuity at all distances. In bilaterally implanted patients, near vision range increased 0.25 D, and intermediate and near distance visual acuities improved by 0.5 lines.
“Previous experience and reports have demonstrated the effectiveness of the IC-8 small-aperture IOL in providing extended depth of focus after monolateral implantation during cataract surgery. The results of our study provide data that bilateral implantation is feasible and effective,” Ang told Healio/OSN. “There was an improvement in intermediate and near vision with bilateral implantation without additional detriment in contrast sensitivity.”
Without reaching statistical significance, bilaterally implanted patients reported more glare and halos than contralaterally implanted patients.
Overall satisfaction was better in the bilaterally implanted patients, although patient selection was cited as a likely factor influencing that result. Patients who received the IC-8 in their second eye were self-selected after having a positive experience with the IOL in their first eye. Patients in both groups said they would undergo the procedure again.
“The implications of these findings are significant because in real-world usage, presbyopia-correcting IOLs are implanted bilaterally and have synergistic effects in providing better distance, intermediate and near vision. Second, small-aperture IOLs have the potential of helping patients with aberrated corneas, and in many cases these problematic corneas are present in both eyes,” Ang said. – by Robert Linnehan
Disclosure: Ang reports he has received grants from AcuFocus and PhysIOL.