Abstract
Purpose: :
To evaluate the long term effect of the IOL-Vip® (IOLs for Visually Impaired People) System intraocular implant and the visual outcome in different forms of macular degeneration.
Methods: :
A retrospective study of 75 eyes of 50 patients (age range 36-85 years) with central scotoma due to different forms of macular degeneration (group I: 41 atrophic ARMD, group II: 17 myopic macular degeneration, group III: 3 macular hole, group IV: 14 Stargardt maculopathy) who underwent phacoemulsification with the implant of the IOL-Vip® system, an intraocular Galilean telescope composed of two IOLs with a magnifying effect of 1.3x (N. Orzalesi, C. Pierrottet, et al.. The IOL-Vip System. A Double Intraocular Lens Implant for Visual Rehabilitation of Patients with Macular Disease. Ophthalmology 114: 860-865, 2007). All patients underwent a preoperative simulation of the magnifying effect and a customized rehabilitation training program. Mean follow-up was 4,2 years (range 6 years - 3 months) and outcome measure was represented by logMAR visual acuity.
Results: :
All the patient but one reported a visual acuity improvement from mean preop 1,3 logMAR to mean postop 0,68 logMAR. Preop simulation fitted with postop result in 78%, overestimated in 1% and underestimated in 21%. Secondary cataract developed in 18% of eyes which was treated with Yag laser capsulotomy. Seven months after surgery one eye in group I developed a wet form of ARMD treated with anti-VEGF. There were no complications related to surgery and the majority of patients were very satisfied of the procedure, though the best results were obtained in group III and IV.
Conclusions: :
The IOL-Vip® system seems to be a safe and reliable procedure even in a long follow-up period. The result is strictly related to the dimension and shape of the retinal lesion allowing a better quality of the preferential retinal locus. Progression of atrophic macular lesions influences the visual outcome in the long period, but the magnifying effect maintains a visual efficacy.
Keywords: age-related macular degeneration • low vision • intraocular lens