21 EyeWorld Asia-Pacific | December 2024 Many physicians have incorporated the IC-8 Apthera (Bausch + Lomb) into their practice, since it was approved by the FDA in 2022. With increased experience, some are discovering ways to apply this technology off-label. Nicole Fram, MD, and Robert Ang, MD, discussed their experience using the lens, including ways that it can apply to patients who previously had limited options, particularly those with irregular astigmatism. CATARACT IC-8 Apthera IOL in a post-LASIK eye. Source: Robert Ang, MD by Ellen Stodola, Editorial Co-Director On- And Off-label Indications For Small Aperture Technology The on-label indication is to put it in the non-dominant eye for extended depth of focus, Dr. Fram said. “They found the sweet spot in the FDA trial to be a target of –0.75 D, which typically achieves good uncorrected distance to 20/25 or 20/30, but also allows for the ability to read at intermediate distance,” she said. “The only caveat is there should be counseling about the dimming that can happen in low light. As you create a pinhole effect, you can see light and some contrast, but it’s mainly relevant in low light settings.” Although Dr. Fram mainly uses small aperture technology in eyes with aberrated corneas, one can also use this technology for patients with regular corneas who might need some extended depth of focus (EDOF) and are not a candidate for an EDOF IOL or a diffractive technology. “Another application for the IC-8 Apthera is in the circumstance where you’re not sure about the exact axis of the astigmatic correction and you need a forgiving technology,” she said. Dr. Ang, who practices in the Philippines, noted the approval in the U.S. for implantation in the non-dominant eye. “The IC-8 Apthera has two unique features that occur simultaneously,” he said. Small aperture optics can extend depth of focus and therefore can be used in presbyopia correction during cataract surgery, similar to other EDOF IOLs. Secondly, small aperture optics filter out aberrations, especially from complex corneas, which distinguish it from any other IOL.
RkJQdWJsaXNoZXIy Njk2NTg0