VISION BOOST FOR DRY AMD

A new intraocular lens (IOL) based on a Galilean telescope concept (iolAMD) is promising technology for safely and effectively improving vision in patients with dry age-related macular degeneration (AMD), Fritz Hengerer MD, PhD told the XXXIII Congress of the ESCRS in Barcelona, Spain.

Dr Hengerer reported that nine patients have received the novel IOL after undergoing surgery for comorbid cataract at Goethe University Frankfurt, Germany. Outcomes from follow-up to one year were presented for three eyes of two patients.

All patients regained reading vision and achieved better than expected improvements in visual acuity (VA). In addition, there were no IOL-related complications or cases with posterior capsule opacification.

“We can conclude that this system is ready for routine implantation during a standard cataract surgery,” said Dr Hengerer, of the Department of Ophthalmology, Goethe University Frankfurt.

The concept for the iolAMD was developed by Bobby Qureshi MD, who sought collaboration from Pablo Artal PhD, to refine the optics. It is an injectable two-lens system comprised of a capsular bag-placed -49D 4.0mm optic lens and a sulcus-placed +63D 5.0mm hyperaspheric optic lens with asymmetrical haptics that results in an offset between the two lenses. Together, they create a 1.3X image magnification on the retina with three degrees of foveal displacement.

“A 15° vault of the capsular bag IOL haptics ensures spacing is maintained between the two lenses, which has been confirmed with Scheimpflug imaging,” Dr Hengerer said.

SIMULATION TEST

Assessment for potential benefit and to determine proper orientation of the sulcus-placed IOL is done preoperatively in a simulation test. Dr Hengerer noted that the sulcus IOL can also be rotated after implantation if needed to compensate for changes in the macula.

The patients implanted with the telescopic IOL had moderate (stage 3) dry AMD with drusen in the fovea leaving them unable to read. Cataract surgery was performed with standard techniques using a superior postero-limbally placed incision to avoid astigmatism induction.

Preoperatively, distance-corrected visual acuity in the three eyes ranged from 20/125 to 20/800; two eyes had no reading vision and corrected near visual acuity (CNVA) was 20/800 in the third eye. Predicted CNVA ranged from 20/100 to 20/200. By day four, uncorrected near acuity was equal to or exceeded the predicted CNVA. CNVA at day 30 ranged from 20/25 to 20/40, and the results were the same at six months.

Dr Hengerer said that additional indications for the telescopic IOL include stable wet AMD, myopic macular degeneration, Stargardt disease, Best disease, and residual macular hole after vitrectomy.

fritz.hengerer@kgu.de