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C. O. Pierrottet, G. Savaresi, P. Ferri, S. Romano, N. Orzalesi; Six Years Experience With the IOL-Vip® Implant in Patients With Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3208.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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.
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