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Visual outcomes after implantation of a new wide-angle IOL in AMD patients


Purpose : To assess visual acuity improvement in patients diagnosed with both incipient cataracts and dry/atrophic age-related macular degeneration (AMD) after cataract surgery with bilateral implantation of a new wide-angle intraocular lens (IOL).

Methods : Three patients were implanted bilaterally with the Eyemax IOLs (London Eye Hospital Pharma, UK). They were diagnosed with dry/atrophic AMD and were graded as level 1-2 of nuclear cataract according to the Lens Opacification Classification System III (LOCS III). All eyes had corneal astigmatism below 1.75 D. The EyeMax IOLs is a single lens conventionally implanted in the capsular bag with an optimized optical design to provide a nearly constant good image quality for retinal eccentricities up to 10 degrees. The IOL’s power was selected to render each eye hyperopic (+3.00 D) after surgery, assuring a retinal magnification effect. Pre and post-surgery uncorrected (UCVA) and best corrected (BCVA) measurements were performed both monocularly (each eye separately) and binocularly at far and near (33 cm) distances. Microperimetry was also measured using the Macular Integrity Assessment (MAIA, Centervue) in order to evaluate the Preferred Retinal Locus (PRL).

Results : After surgery, the spherical equivalent refractive error of all eyes varied between +2.50 and +3.25 D with astigmatism values bellow 2.00 D. The intersubject mean value of LogMAR VA increased 46±21%. In two patients, monocular and binocular pre-surgery BCVA at both viewing distances ranged from 0.4 to 0.8 LogMAR. In the other one, pre-BCVA was worse than 0.8 LogMAR in all conditions. In both eyes with better pre-BCVA, monocular BCVA improved between 0.2 and 0.4 LogMAR and binocular BCVA achieved values equal or better than 0.20 LogMAR. In the other case, although the monocular BCVA also improved 0.2 LogMAR, the binocular BCVA remained in low values of 1.0 LogMAR. Post-BCVA values were higher than those corresponding to the PRL of each eye.

Conclusions : We found a significant improvement in visual acuity after Eyemax IOL implantation specially in those patients with a higher pre-surgery BCVA. AMD patients with cataracts implanted with Eyemax IOLs bilaterally could improve their visual acuity exceeding the physiological values corresponding to their retinal fixation area.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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