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An evaluation of the effectiveness and safety of intra-ocular lens systems in patients with age-related macular degeneration: a systematic literature review

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First Author: M.Johnson UK

Co Author(s):    G. Almeida                    

Abstract Details

Purpose:

AMD is the leading cause of visual impairment in the UK, and within industrialised nations Standard IOLs are designed to focus light onto the fovea. In patients with AMD, this is the area with greatest functional loss, and thus traditional IOLs offer limited benefit to this patient group. Whilst research is attempting to find new therapeutic options for AMD, the population growth and increasing longevity emphasise the need for new management options. This review aims to examine the intra-ocular lens systems that are currently available and assess their effectiveness and safety as visual aids for AMD patients.

Setting:

Systematic Literature Review.

Methods:

A detailed literature search of major medical electronic databases – Medline, Embase, and the International Clinical Trials Registry Platform (ICTRP). Complimented with a manual search of bibliographies and a hand search of popular ophthalmology journals. The primary outcome measure of interest was BCVA. With secondary measures of visual function, quality of life, and complications. The search protocol will include medical subject headings (MeSH) and free text. The following keywords were “age-related macular degeneration”, “macular degeneration”, intraocular lens”, “intra-ocular lens” “telescopic lens”, “telescope”, “telescopic implant”, “AMD lens”, “AMD implant”. Searches incorporated the Boolean operators “AND” / “OR”.

Results:

A total of ten devices were identified of which seven are included in this review. The remaining three have no published or insufficient results at present. BCVA was reported in all studies to improve post-operatively with each device. Across the studies safety profiles were similar to cataract surgery, except for one device the IMT, that was in much larger in size and geometry.

Conclusions:

There is a paucity of evidence in this relatively new field. No randomised controlled trials in this area exist, and current studies are too small to come to a reliable conclusion as to the effectiveness of these implants. Importantly AMD is a progressive disease and a better understanding of its pathogenesis would enable a facilitate the optimal intra-ocular lens systems design.

Financial Disclosure:

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