Abstract
Purpose: :
To evaluate the safety of a new surgical procedure for low vision patients with central scotoma, based on the intraocular implant of the IOL–Vip® System.
Methods: :
40 patients (50 eyes) with stable macular degeneration underwent phacoemulsification with the implant of the IOL–Vip® system, which consists of a biconcave high minus power IOL in the capsular bag and a biconvex high plus power IOL in the anterior chamber, reproducing an intraocular Galilean telescope with 1.3x magnification for distance. To evaluate the potential damage of the double implant for the cornea and the iris, all of the patients underwent biomicroscopic examination and endothelial cell count before surgery and after an average follow–up of 24 months (range 7–40 months).
Results: :
The double IOL implant was well tolerated in all cases and none of the patients had severe complications. Three of the first five cases developed a pupillary block with increased IOP in the days following surgery, which was promptly managed by means of Yag laser iridotomy. Because of this, preoperative iridotomy was performed in all of the other cases. The mean preop endothelial cell count was 2716, mean postop count was 2513, with 7% decrease. The preop lowest count patient decreased from 1783 cell/mm2 to 1603 cell/mm2 (10% decrease) 7 months after surgery and the case with the longest follow–up went from 2035 to 1896 after 35 months (7% decrease). Biomicroscopic appearance of the iris and pupil remained normal.
Conclusions: :
The implantation of the IOL–Vip system did not cause significant serious adverse events. and complications did not exceed those of routine phacoemulsification. Despite the space occupied by the two IOLs in the anterior segment of the eye, the double implant did not damage adjacent ocular structures, as the corneal endothelium and the iris. Considering the functional effectiveness of the IOL–Vip procedure (Invest Ophthalmol Vis Sci (Suppl) 3737–B198, 156, 2004), this device represents a valid option to improve visual functions and quality of life in patients with macular diseases.
Keywords: low vision • age-related macular degeneration • aging: visual performance