Seems like this IOL (which functions like the Kamra inlay) is getting great results in Europe and elsewhere and will hopefully be coming to the US in the next year or two. Sounds like it could be as good of an option as the EDoFs but without all the nighttime issues of glare and halos like my Symfony has. Makes me wonder if it would be worth swapping out my Symfony for this and getting the recommended distance monofocal in my dominant eye. Thoughts?
You may not have the issue of glare or halos with the Acufocus IC-8 IOL, but your capability to see well in low light will suffer because of the reduced effective pupil size. There is a reason why the human pupils (just like most animals) get wider at night. Taking that capability away is a big compromise.
Everyone can see objects over an increased range by looking through a pin hole, but I am not sure if I would want my IOL to provide that pin hole effect.
And I will also be curious to know what an ophthalmologist will think of a person with the AcuFocus lens, whose eyes can't be dilated enough during an eye examination for him/her to check the retina etc as well as it should be.
Yes, I was thinking both things but apparently it doesn't prevent them from seeing the retina and performing other procedures. The information I have seen is that the reduced light is only noticeable when it is compared to the other eye but that binocular vision is fine. I would like to hear the experiences of people that got the Kamra inlay as that works the same way as the IOL, especially if the reduced light is bothersome at night.
Hi John
I am also experiencing lots of glare and starbursts and am considering having it changed for the IC-8.
I cannot find any patient reviews of this lens only clinical trial results which is a bit strange.
Have you found any patient reviews?
Tom
No patient reviews yet as it is not approved in US yet but thought someone with the kamra inlay might respond. I did see it mentioned that it had a higher incidence of floaters, maybe related to the pinhole effect. While it may not cause severe halos, I would think it would be better during the day as well compared to the nighttime since it cuts down on the amount of light that enters the eye. I guess with all the IOLs there are tradeoffs.
Couldn't a contact lens be created that gives a pinhole effect?
That would seem to be a better solution if someone wanted that effect but could easily be removed when needed.
That's really good question, not sure why they insert into the cornea instead of just use a contact lens. I will try to remember to ask the doc when I see him in 2 weeks
In the day time, in good light, the pupil is already small any way. That is why one can see better in good light.
Thus, the additional benefit in day light due to Acufocus IC-8 IOLwill be minimal, if any.
Kamra inlay is 3.8 mm in diameter (about 1/4 the size of a soft contact lens) and 6.0µm thick.
IC-8 IOL has a total diameter of 3.23mm, a thickness of 5.0µm and 3,200 microperforations.
Karma corneal inlay surgery left one's natural lens untouched. It is considered a non-invasive procedure and reversible.
IC-8 IOL is implanted to replace the aging lens of a cataract patient. May be more suitable for people with small capsular bags ... unless it is sitting on top of another lens.
For comparison purposes, TECNIS Symfony IOL has an overall diameter of 13.0mm, with an optical zone of 6.0mm
For comparison, the human pupil size is typically between 2 and 4 mm in diameter during good day light, with the lower value corresponding to brighter light (with some variations between people).
Thus, Karma (3.8 mm dia) as well as IC-8 IOL (3.23 mm dia) are not expected to have much effect on the quality of the day time vision.
.. unless these pinhole lenses are meant to sit on the natural lenses or on other IOLs.
This is the specification.
note; the pin hole aperture is only 1.36mm.
IOL Material
– Hydrophobic acrylic
• IOL Design
– Single-piece
– Biconvex, anterior aspheric surface optic
– 6.0 mm optic diameter
– 12.5 mm overall length
– Modified C haptic with 5° angulation
• Mask Design
– Polyvinylidene fluoride (PVDF) and nano-particles of carbon
– 1.36 mm aperture
– 3.23 mm total diameter
• A-Constant for Optical Biometry:120.5
• A-Constant for Ultrasound Biometry: 120.15
• Surgeon Factor: 2.64
• Diopter Range: +15.5 D to +27.5 D (0.50 D steps)
Hi John
I have had a symfony exchanged for an IC-8 and my description has been posted
Pinhole looks a good thing wearing pinhole glasses: the corneal aberrations are cut off and you can read well, but it’s something OUT your eye. Once the lens is INSIDE your eye, you’ll sight will be darkened, sometimes to the point you wont be able to drive at night. Not a good thing.
Maybe that’s why it’s only implanted in one eye, with a different IOL implanted in the other (if needed).
would that have an impact on depth perception?
I don’t know enough about it, but I assume the appropriate measurements and optimizations are done. From what I read awhile back, the IC-8 is generally implanted in the non-dominant eye and a monofocal is implanted in the dominant eye. One article noted some loss of night contrast sensitivity, but said it didn’t affect function.
I’m getting tbe IC-8 IOL on Wednesday. Anyone on here have this lens?
I will update on my experience.
I’m in Australia, where I believe this lens has been approved for a couple of years.
Over the past several months I have been reading everything I could find on the IC-8.
In this thread so far, there is a lot of misinformation and uninformed speculation, presented as fact, that is contradicted by the actual scientific evidence. I think if anyone described a 747 to an audience that had never seen an airplane fly, many would confidently post that a 900,000-lb metal machine could not fly. As always, it’s wise to look at evidence before passing judgement.
The IC-8 has been very well received. Some trials ended up reporting on bilateral implantation. They started out intending to do only one eye in each patient, but some of the trial subjects liked the first one they got so much they insisted on having it in the other eye as well. And they liked it. Subjects receiving bilateral implantation achieved higher visual accuity – half achieved 20/16, while no unilateral subjects achieved better than 20/20.
It’s hard to imagine how the IC-8 would have the high patient satisfaction scores it has if it gave great difficulty in night driving. See the article “The IC-8 IOL: Big Advantages Through Small Apertures .” Quote from that article:
“Auffarth and Srinivasan state that none of their patients has reported significant night vision difficulties; similarly, Beltz reports that her patients have very high satisfaction with vision in dim light: ‘The mean satisfaction scores for dim light and bright light vision were equivalent.’”
It’s aperture is only 1.3 mm, yet you can see at night. It is 900,000 lbs, yet it can fly.
The lens has been sold for years in Europe, Australia and some other countries. It was approved by the FDA here in July. At the recent ophthalmologists convention, the manufacturer’s reps told my ophthalmologist distribution here (USA) would begin in the first quarter of 2023.
If you want a summary of all the published clinical results to date, search for “Small Aperture IC-8 Extended Depth of Focus Intraocular Lens in Cataract Surgery: A Systematic Review.”
Here is a quote from the abstract:
“Significant
improvements in uncorrected distance visual acuity (UDVA); uncorrected intermediate visual acuity
(UIVA); uncorrected near visual acuity (UNVA); perception of photic phenomena; and patient
satisfaction have been reported. Unilateral and bilateral small aperture IC-8 IOL implantation reduces
photic phenomena and provides good vision for all distances with high patient satisfaction and
minimal postoperative complications.”
From the results section:
“Regarding patient satisfaction, Grabner et al. [24], Dick et al. [25,26], Hooshmand et al. [27],
Ang [41], Ang et al. [28], and Schojai et al. [29] assessed this variable with the satisfaction
questionnaire score, where a score of 1 indicated very dissatisfied and 10 very satisfied.
All these studies reported a high satisfaction questionnaire score after small aperture IC-8
IOL implantation.” (Most were in the 8 to 9 range).
On the question of seeing in dim light – Ang (Visual Performance of a Small-Aperture Intraocular Lens: First Comparison of Results After Contralateral and Bilateral Implantation) gives the most thorough report:
“Under mesopic conditions (bottom left and bottom right), the mean log contrast sensitivity was on average approximately 0.2 log units lower in the IC-8 IOL eyes compared to monofocal eyes, although none of the differences was statistically significant at any spatial frequency with or without glare conditions (P > .05).”
I confirmed with my ophthalmologist that 0.2 log units is pretty close to bupkis . Note that they could not reject the null hypothesis at the 5% level. And this is testing one eye at a time. When binocular vision was tested in other studies, with unilateral implantation of the IC-8 and a conventional monofocal in the fellow eye, there was no difference in contrast sensitivity vs. patients with conventional monofocals in both eyes.
Night driving satisfaction scores were slightly HIGHER for those who got bilateral implantation of the IC-8, Ang said. However, it was a biased sample in that only those who requested the IC-8 for the second eye got it. So, this group probably had the best results on the first eye. The unilateral subjects did not request IC-8 for the second procedure and got a standard monofocal in the other eye.
All 20 of Ang’s subjects said they would choose the IC-8 again if they had it to do over.
According to an article (Ring Me Up) in the April 15 2022 Review of Optometry “It is a one-piece hydrophobic, acrylic IOL with a 6mm optic zone, 12.5mm length and powers that range from +10D to +30D in 0.50D steps.”
Please note this contradicts information posted in this thread by others, in regard to over-all size (it is 12.5mm) and range of powers (it is 10D to 30D). Someone already corrected the over-all size info. This corrects the range of powers.
The IC-8 is the only non-toric lens that can correct astigmatism. It’s good up to 1.5 d of cyl. That’s a great thing, since it does not depend on the doctor getting the axis right and the lens not rotating.
The IC-8 solves some really gnarly vision problems caused by higher-order aberrations in the cornea.
I am wavering about whether to get the IC-8. I don’t care that much about being glasses free but I care a lot about having the best possible vision for the task at hand. That probably means conventional monofocals and two different pairs of glasses. But, that thinking could change.