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Uwe Oberheide, Omid Kermani, Georg Gerten; Implantation of an add-on intraocular lens for patients with age-related macula degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3112.
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© 2017 Association for Research in Vision and Ophthalmology.
Reduced near visual acuity is still a major problem with all forms of AMD. External magnifying low visual aids are common option for patients with age-related macula degeneration. For patients with cataract various intraocular lenses (IOLs) or telescopic systems have been described but mostly require phakic status of the eye.In pseudophakic patients with advanced AMD a novel add-on IOL with a central 9.5 D zone of 1.5mm in diameter and refractive neutral outer zone (AddOn® SML A45AMD, 1stQ, Germany) was implanted to increase near visual acuity. Main effects are the magnification due to the smaller distance and utilization of near miosis.
Modelling of the eye with an optical design software (Winlens, Qioptiq, Germany) showed that magnification is dependent on the anatomy of the eye and the final reading distance.The hydrophilic acrylic add-on IOL was implanted in the ciliary sulcus in 4 pseudophakic eyes of 4 patients with progressed AMD. The corrected distance visual acuity (CDVA) and the corrected near visual acuity (CNVA) with an add of +6 D and 15cm reading distance for simulation of the optical effect of the IOL were measured.
The implantation of the IOL was uneventful in all 4 cases. 2 weeks postoperatively the patients were able to read at a distance of 15cm. Binocularity is reduced only at reading distance but not at far distance. At reading distance, the image of the contralateral eye is blurry and does not cause diplopia. The decimal CDVA remained unchanged in all eyes at 0.1 (2 patients), 0.16 and 0.2. The decimal CNVA corresponded to the preoperative CNVA at 15cm with +6D add ( 0.1 and 0.4 (3 patients)).
Although these are first results of the implantation of a novel add-on IOL in a limited number pseudophakic patients with AMD the effect of improved near visual acuity is promising. The quality of life for the patients improved by getting rid of external magnifying low vision aids. To verify the effect long term studies with a larger amount of patients is necessary.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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