Posters

A new add-on intraocular lens for pseudophakic patients with macular disease

Poster Details

First Author: F.Badala ITALY

Co Author(s):    E. Bona                    

Abstract Details

Purpose:

To determine short-term safety and visual outcomes of a new ciliary sulcus-implanted add-on intraocular lens (IOL) designed to modify the optics of pseudophakic eyes previously implanted with standard monofocal IOLs, in order to optimise image quality at the preferred retinal locus (PRL) in patients with macular disease.

Setting:

Private Eye Institute (Micro Chirurgia Oculare, Milan, Italy)

Methods:

Twentysix eyes with visual loss secondary to dry age-related macular degeneration (AMD), stable wet AMD or myopic macular degeneration underwent 2.4mm clear corneal incision and ciliary sulcus-implantation by injection (Accuject, Medicel, Switzerland) of a novel, soft hydrophilic acrylic IOL designed to optimise image quality across the macula in all areas <10 degrees from the centre, in pseudophakic eyes (EyeMax Add-on; LEH Pharma, UK). All eyes had undergone previous standard cataract surgery and monofocal IOL implantation. White-to-white (WTW) diameters (IOLMaster, Carl Zeiss Jena, Germany) were used to determine suitability for 12.25mm (>11.3mm WTW) or 11.5mm diameter (≤11.3mm WTW) IOL implantation.

Results:

Mean age was 78 years; Two patients underwent bilateral implantation. Mean pre-operative spherical equivalent (SE) was -0.9D (±1.3 SD); mean post-operative SE was +2D (±1.4 SD); mean of differences was 3D (±0.6 SD). Mean follow-up was 5.5 months (1 -10 months). Mean pre-operative intraocular pressure (IOP) was 14mmHg (11 – 17mmHg); mean post-operative IOP was 14mmHg (range 11 – 16mmHg). There were no complications. Mean pre-operative corrected distance visual acuity was 48 ETDRS letters (CDVA; range 4 – 77); mean post-operative CDVA was 62 ETDRS letters (20 – 80); mean of differences was 14 ETDRS letters (±7.5 SD; p<0.01).

Conclusions:

Standard monofocal IOLs are designed prioritise image quality at the foveal centre and consequently afford poor image quality in other macular areas - this has implications for patients using eccentric fixation for activities of daily living. The EyeMax Add-on IOL, which has a hyper-wavefront-modified optic and modified four-loop haptic design, is designed to correct for this. Our results indicate that EyeMax Add-on implantation is safe in the short term and that it is possible to improve visual acuity in eyes with macular degeneration by optimising image quality at the PRL, despite reduced cone densities at increased retinal eccentricities.

Financial Disclosure:

None