IOLs can improve vision in AMD

Hyperaspheric IOL provides good results in patients with maculopathy

Roibeard O’hEineachain

Posted: Friday, December 7, 2018

Federico Badala MD

The Eyemax™ (London Eye Hospital Pharma) enhanced breadth of focus IOL can improve distance and near vision in eyes with cataracts and macular disease, said Federico Badala MD, Milan, Italy.

“As cataract surgeons we are all aware of the concept of changing asphericity to increase depth of focus. This lens introduces a new concept, which is the use of transverse asphericity. It is well known that longitudinal asphericity can be used to change depth of focus. For the first time, the Eyemax uses both longitudinal and transverse asphericity to increase breadth of focus,” Dr Badala told the 36th Congress of the ESCRS in Vienna Austria.

He noted that the Eyemax IOL is an injectable, hydrophobic acrylic lens designed to improve the quality of retinal image in all areas of the macula up to 10 degrees from fixation, therefore patients with central macular scar but relatively healthy surrounding macula can benefit from this implant. Designed for insertion into the capsular bag, the lens has an optic diameter of 6.0mm, an overall length of 11mm and modified C-loop haptics.

Dr Badala presented his findings from a prospective case series of 96 eyes with cataract and maculopathies that underwent standard phacoemulsification with Eyemax IOL implantation. All had at least six months’ follow-up (range six-18 months). All patients were left intentionally hyperopic to get additional magnification from spectacle correction.

He noted that visual acuity improved significantly in all patients. Corrected distance visual acuity improved by a mean of 14 EDTRS letters overall. Among those with macular dystrophies, including retinitis pigmentosa, Best’s Disease and Stargardt’s disease, there was a gain of 11-12 letters, but among those with AMD there was a gain of 16 letters.

He added that although the implant can be used in one eye without inducing aniseikonia, patients implanted bilaterally achieve a better than expected outcome.

“We hypothesise that when the lens is implanted in both eyes the brain receives the good image from each eye and neuroadaptation sums up the two images and gives the patients a better ability to read,” Dr Badala explained.

He added that it is unlikely that the visual improvement is simply due to the removal of the cataract, since reports in the literature show similar patients gaining only 6.5/7.5 ETDRS letter following cataract surgery with conventional IOL implantation.

“The Eyemax IOL shows promising results in improving distance and near vision in eyes with cataracts and macular degeneration. Near visual acuity seems to benefit more than distance visual acuity. Patients implanted bilaterally seems to get a better outcome,” he summarised.

Federico Badala: