The efficacy of Iol-vip revolution" telescopic intraocular lens implantation in age-related macular degeneration cases with senile cataract

Purpose: To evaluate the efficacy of the IOL-Vip (Intraocular lens for visually impaired people) Revolution telescopic intraocular lens (IOL) in Age-related Macular Degeneration (AMD) patients with senile cataract. Materials and Methods: This prospective nonrandomized, interventional case study was carried out at Ege University School of Medicine, Retina Unit of Ophthalmology Department. Thirteen eyes of 12 AMD patients (end stage non-vascular or stabilized neovascular type AMD) with senile cataract were enrolled to the study. Selection of the patients were carried out by means of a low vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates residual visual function. The software designs the rehabilitation strategies (Newinflash) based on preoperative and postoperative training of the preferred retinal locus. Rehabilitation program was applied 2 weeks during the preoperative period and 4 weeks during the postoperative period.After the standard phacoemulsification surgery, incision site was enlarged and "IOL-Vip Revolution" was implanted to the capsular bag. The patients were examined during the postoperative period on the 1st day, 5th day, and within the 1st, 2nd, and 3rd months. Outcome measures were visual acuity, contrast sensitivity, anterior chamber depth, endothelial cell density, CCT and National Eye Instute Visual Functioning Questionnaire–25 (VFQ-25/TR). The statistical analysis was performed using SPSS software for Windows version 17.0 (SPSS Inc, Chicago, Illinois, USA). Results: The male/female ratio was 7/6 among the subjects. The mean age was 72.31±8.53 (57–85) years. The mean positive power of the IOL was 59±2 D and the negative IOL power was standard (-46D). The mean BCVA at the operated eye before and after the surgery were 1.08±0.14(0.8-1.3), 0.81±0.16 (0.56–1.1) logMAR, respectively (p=0.005). The mean BCVA at the non-operated eye before and after the surgery were 1.13±0.36(0.66-1.8) logMAR, 1.01±0.40(0.56-1.8) logMAR, respectively (p=0.021). A statistically significant increase in quality of life and ACD was detected (p=0.018, 0.008). A significant decrease in endothelial cell density was observed (p=0.002). No significant difference was detected in CCT and contrast sensitivity. (p=0.133, 0.684). The mean follow up period was 6.38±2.93(3–10) months. No intraoperative complication was recorded. As a postoperative complication, acute angle-closure glaucoma was detected in one patient. Subjectively, IOL-Vip Revolution system was tolerated well. Discussion: These early results showed that IOL-Vip Revolution telescopic IOL usage is a promising treatment option in AMD patients with senile cataract. It was well tolerated by the patients and was found to be safe. Rehabilitation program may have an important role in the restrored clinical results, which also provides a visual improvement at the nonoperative eyes.