Surgically inducing a telescopic optical system shows benefit for AMD patients with cataract

Surgically creating a telescopic optical system using IOLs and spectacles may improve functional vision in patients with both cataract and age-related macular degeneration, according to a study by researchers in Canada.

Megumi Iizuka, MD, FRCSC, and colleagues at the University of Toronto evaluated visual outcomes in six patients who underwent cataract surgery in their weaker eye. All treated eyes had large atrophic dry AMD and best corrected visual acuity of 20/400 or worse, according to the study.

"The power of the [IOL] was derived from the reduced Gullstrand model of the eye in such a way that at the [IOL] plane a minus lens was created, which, together with a plus lens in matching glasses, formed a Galilean telescopic system with magnification of up to 33%," the authors said.

Surgeons implanted IOLs with an average power of 6.31 D and achieved an average 26% magnification, ranging from 20% to 30%, the authors reported.

Visual acuity improved in all eyes, from a mean of 20/525 preoperatively to 20/290 at follow-up. Contrast sensitivity also improved significantly (P < .001), although the improvement was reported only in the lower spatial frequencies, according to the study.

Postoperatively, activities of daily living scores significantly improved in all but one patient.

In addition, at the end of follow-up, three patients expressed their intent to receive similar surgery in their fellow eye, the authors noted.

The study is published in the December issue of Canadian Journal of Ophthalmology.