Pinhole IOL

A new IOL that uses pinhole effect provides increased depth of focus

Roibeard O’hEineachain

Posted: Friday, July 6, 2018

The IC-8 lens from AcuFocus placed in the eye

A new presbyopic intraocular lens (IOL), the IC-8 (AcuFocus), that incorporates the pinhole effect of the Kamra (AcuFocus) presbyopic corneal inlay appears to provide a high degree of spectacle independence without sacrificing distance vision, according to a study presented by Matteo Piovella MD at the 22nd ESCRS Winter Meeting in Belgrade, Serbia.

“The IC-8 showed excellent visual performance at three years. IC-8 in the non-dominant eye, combined with best technology aspheric monofocal IOL in the dominant eye, provided excellent binocular distance vision. It also provided intermediate and near vision and there is no need to wear presbyopic glasses,” said Dr Piovella, Monza-Milan, Italy.

The study included 19 cataract patients with a mean corneal astigmatism of 1.25 who underwent an IC-8 IOL in the non-dominant eye and either an aspheric monofocal IOL or retained their natural lens in the dominant eye. The patients were aged 45 years or older, had clear intraocular media apart from the cataract and a best corrected distance visual acuity of 20/30 or worse, as a result of the cataract. The refractive target was plano in the dominant eye and a slight myopia of -0.75 sphere in the non-dominant eye implanted with the IC-8 lens

At three years’ follow-up, the mean uncorrected distance visual acuity (UDVA) in the eyes with the pinhole IOL was 20/22, the mean uncorrected intermediate visual acuity (UIVA) was 20/27 and the uncorrected near visual acuity was (UNVA) 20/26. In the monofocal eyes, the mean UDVA, UIVA and UNVA were 20/19, 20/31 and 20/64, respectively. Binocularly, mean UDVA was 20/19, mean UIVA was 20/24 and mean UNVA was 20/27.

Dr Piovella noted that like the Kamra inlay, the pinhole mask within the IC-8 IOL is composed of polyvinylidene fluoride and nanoparticles of carbon. It has a 1.36mm aperture, a total diameter of 3.23mm, a thickness of 5.0µm and 3,200 microperforations.

He pointed out that the increased depth of field that the IOL’s pinhole effect provides compensates not only for the slight myopic refraction of the lens, but also for up to 2.0D of astigmatism. It therefore eliminates the need, in most eyes, for toric IOLs, along with their associated complexities.

“You don’t need to manage the toric correction, you don’t need a toric IOL and you don’t need to get an IOL on the perfect axis. And automatically, due to this characteristic, if you surgically induce astigmatism, this technology will also take care of that,” Dr Piovella added.

Matteo Piovella: