A case report detailing use of a new intraocular lens with advanced technology, designed specifically for patients with center-involving macular disorders

Abstract

Rationale: Many studies have shown that cataract surgery can be performed safely and improve visual acuity, without increasing the risk of progression of existing age-related macular degeneration (AMD). Data are emerging for an intraocular lens (IOL) that utilizes an advanced optical design to optimize the image supplied to all areas of the macula and not just the foveal center, which may benefit patients with center-involving macular disorders. Patient concerns: An 83-year-old Caucasian female presented with poor contrast sensitivity and color perception with increasing glare over the preceding year. Diagnosis: She had a progressive cortical cataract and stable dry AMD in the left eye, and wet AMD in the right eye. In the left eye, preoperative best-corrected distance visual acuity (BCDVA) was 0.2 (decimal) and best-corrected near visual acuity (BCNVA) was 0.05 (decimal). Interventions: Standard small-incision phacoemulsification was performed in the left eye, with capsular bag implantation of EyeMax Mono (LEH Pharma, London, UK), a single-piece, soft, hydrophobic, acrylic IOL designed to optimize image quality across the macula, rather than a standard monofocal lens. Outcomes: At 6 months postoperation, visual acuity in the left eye had markedly improved, with a BCDVA of 0.5 (decimal) and a BCNVA of 0.2 (decimal). Conclusion: In this first case undertaken at our center (and the first in Austria), cataract extraction and EyeMax Mono implantation were performed safely, with good subjective and objective outcome measures consistent with the effects of image optimization across the macula. Further studies of this IOL in patients with center-involving macular disorders, such as AMD, are warranted.

Intraocular vision-improving devices in age-related macular degeneration

“…In Austria, the first case report published in 2019 shows an 83-year-old Caucasian female with stable AMD in both eyes and did the operation on the left eye. It turns out after 6 months follow-up that her BCDVA improved from 0.2 to 0.5 (decimal), and BCNVA improved from 0.05 (decimal) to 0.2 (decimal) with no further long-and short-term complications (34).…”

“…One of the most advanced parts is to provide a high-quality image with reduced blur in those areas where photoreceptor cell densities may still afford VA of 6/30 Snellen or better. It's a new class of injectable, soft acrylic, extended macular vision IOLs (34) and permitting subjects to form single or multiple PRLs from their normal part of the macula as much as possible (35). There are two versions of the EyeMax mono: one is designed for capsular bag implantation following phacoemulsification.…”

Improving Outcomes for Patients with Age-Related Macular Degeneration and Cataracts: The Importance of Including an Assessment of Activities of Daily Life (ADL)

“…4,15,17 iolAMD, and its successor EyeMax Mono, which use a hyperaspheric design to improve the quality of retinal image to all areas of the macular within 10° of eccentricity of the foveal centre when compared with standard monofocal IOLs. [18][19][20][21] Scharioth Macula Lens, which aims to improve near vision of pseudophakic eyes, without affecting peripheral vision or binocularity at distances further than 15cm. 4,15,[22][23][24] Fresnel Prism Intraocular Lens, which relocates the image to a healthy area of the retina.…”