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Patients implanted with telescope prosthesis face unique vision rehab challenges

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NEW ORLEANS — Patients implanted with the Implantable Miniature Telescope face postoperative vision rehabilitation challenges that require in-depth pre- and postoperative training, according to a speaker here.

With the Implantable Miniature Telescope (IMT), being developed by VisionCare Ophthalmic Technologies, patients perceive different-sized images through each individual eye, and decreased peripheral vision in the implanted eye, Lylas F. Mogk, MD, said at the American Academy of Ophthalmology meeting.

Additionally, patients will experience decreased contrast sensitivity and increased glare, though these complications are not unique to the IMT, she said. Dr. Mogk based her assertions on previous studies that have been conducted of the device.

"With respect to the disparate images from each eye, VisionCare's stated rehabilitation goal is for implanted patients to keep both eyes open, suppress the information from one or the other eye, and switch back and forth at will with a small prompt, such as a blink," Dr. Mogk said. "The ramifications of using each eye separately include loss of depth perception."

Patients will experience difficulties picking up objects, descending and ascending steps and moving past or on curved or irregular surfaces, she said.

"This is further exacerbated by the second unique visual challenge, which is decreased peripheral field in the implanted eye," Dr. Mogk said.

Because the patient uses the implanted eye for details, the fellow eye must be exclusively used for mobility, she explained. Patients may have problems with balance and, therefore, should undergo preoperative training with an external telescope that simulates what they will see with the implant, Dr. Mogk said.

"It's clear that patient selection is a critical matter," Dr. Mogk said. "Patients must be willing to work at rehabilitation."

VisionCare has developed a training protocol for the device, which physicians implanting it are required to implement.