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IOL telescope system offers potential for functional vision in patients with severe end-stage AMD
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BOSTON — A combination of an anterior chamber IOL and posterior chamber IOL that functions like a Galilean telescope offers reasonable visual recovery for patients with sight-threatening age-related macular degeneration, according to a speaker.
"The IOL-Vip system (LenSpecial) seems to be a promising new device for visual rehabilitation of patients suffering from an end-stage of macular degeneration. However, complete visual rehabilitation is never possible," Ramin Khoramnia, MD, said at the annual meeting of the American Society of Cataract and Refractive Surgery.
In seven eyes of seven patients with a mean best corrected visual acuity preoperatively of 1.3 logMAR, patients had a mean improvement of 0.68 logMAR, Dr. Khoramnia said. All patients reported an improvement in quality of life after implantation.
There were no intraoperative or postoperative complications noted with the device; however, patients experienced an average of 6% endothelial cell loss after surgery and 10% during the first year after implantation. Additionally, there was a mean postoperative spherical equivalent of +4.5 D in patients implanted with the system.
The restoration of functional vision is an acceptable target. Patients who have advanced macular degeneration — the patients whom these types of implants target — can certainly benefit from an improvement in functional vision. In the past, we’ve always addressed these patients by trying to measure their Snellen acuity. But these patients have damage that makes the measurement of Snellen acuity not the best endpoint for what we’re trying to achieve. If you take a patient who maybe measures 20/100, they have a certain functional capability. If you’re able to take an implant such as this, while not improving their absolute measureable level of reading (Jaeger), but improve what they can functionally do — whether it’s reading or some form of distance vision or recognizing people — then that’s a potential improvement of their quality of life.
– Jeffrey S. Heier, MD
Ophthalmic
Consultants of Boston
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