Achieving Functional Vision in Patients Seeking Freedom From Glasses

EP: 1.Expanding the Depth of Focus With IC-8 Apthera IOL

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EP: 2.Achieving Functional Vision in Patients Seeking Freedom From Glasses

EP: 3.Enhancing Vision With Small Aperture Extended Depth of Focus IOLs and Adjunctive PRK in Patients With Keratoconus

Achieving Functional Vision in Patients Seeking Freedom Grom Glasses

This case involves a 40-year-old female patient seeking refractive lens exchange to achieve freedom from glasses. She presented with minimal distance correction needs but significant lifestyle requirements including extensive computer use and nighttime activities, with a strong preference for glare-free vision. Her desire to avoid glare directed the surgical team away from trifocal or other presbyopia-correcting intraocular lenses (IOLs) toward the IC-8 small aperture lens as the optimal long-term solution.

The patient's initial surgical course became complicated when she received a light adjustable lens (LAL), which proved problematic for several reasons. Living in Florida while being treated in Minnesota raised concerns about LAL shield breakdown in sunny environments. Following the initial LAL implantation and subsequent light treatments, the patient experienced deteriorating vision quality with unpredictable refractive changes, persistent ghosting, and visual disturbances including seeing multiple images of traffic lights. Multiple interventions including additional light treatments, YAG capsulotomy, topography-guided LASIK, and LASIK enhancement failed to resolve her visual complaints, resulting in 22 clinic visits and significant patient frustration.

The case was ultimately resolved through lens exchange to the IC-8 small aperture IOL. Before proceeding with surgery, the patient was tested with a pinhole occluder, which immediately demonstrated the potential benefit of small aperture optics by providing crisp, clear vision at all distances. Following IC-8 implantation, the patient achieved 20/20 uncorrected visual acuity with excellent manifest refraction and, most importantly, high-quality vision at distance, intermediate, and near ranges. This case demonstrates how small aperture optics can successfully salvage complex cases where other premium IOL technologies have failed, transforming a frustrated patient into a satisfied one through the unique optical properties of the pinhole effect.