Abstract
Abstract: :
Purpose: To establish the efficacy and tolerance of a new intraocular magnifying device (IOL–Vip® (Visually Impaired People) System) in patients with cataract and low vision due to macular degeneration. Methods: 11 patients (age range 57–82 years) with different forms of macular degeneration (6 disciform scars or atrophic AMD, 2 myopic macular degeneration, 1 macular hole, 1 disciform scar in angioid streaks and 1 Stargardt’s disease) underwent facoemulsification with the implant of the IOL–Vip® system. This double–IOL system is made of a negative biconcave IOL to be put in the capsular bag and a positive biconvex IOL to be put in the anterior chamber. It reproduces a sort of Galilean telescope with 1.3X magnification for distance. Suitability for the surgical implant was established in all cases with functional and ocular evaluation, by means of the IOL–Vip® dedicated software, which estimates distance and near best corrected visual acuity, Preferred Retinal Locus (PRL) (objective and subjective), visual improvement with simulation of the magnifying effect of the IOL–Vip® system. The IOL–Vip® software also indicates the rehabilitation training program for the PRL, before and after surgery. Results: Follow–up visits were performed every three months and all the patients were followed for at least one year. The system was well tolerated, but in 9 patients a YAG laser iridotomy was performed to avoid pupillary block (6 pre–op and 3 post–op). All the patients, except one, showed visual acuity improvement, assessed with the Subvision charts, as well as an improvement of daily living activities. Conclusions: This pilot study shows that IOL–Vip® system represents a safe and effective surgical procedure for patients with low vision due to macular conditions. The low magnifying effect, induced by the IOL–Vip® system, does not limit the peripheral visual field and patients can retain binocular vision. Other clinical studies are recommended.
Keywords: low vision • cataract • age–related macular degeneration