Mirror telescopic intraocular lens for age-related macular degeneration: design and preliminary clinical results of the Lipshitz macular implant
(Un système de miroir télescopique intra-oculaire dans le cadre de la dégénérescence macualire liée à l'âge : Conception et résultats cliniques préliminaires de l'implant maculaire de Lipshitz)

Agarwal A, Lipshitz I, Jacob S, Lamba M, Tiwari R, Kumar DA, Agarwal A.

Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. dragarwal@vsnl.com

PURPOSE: To conduct a pilot study evaluating the visual and surgical outcomes of an intraocular mirror telescopic intraocular lens, the Lipshitz macular implant (LMI) (Optolight Vision Technology), for age-related macular degeneration (ARMD) and other macular pathology

METHODS: The LMI was implanted in patients with bilateral macular pathology and visual acuity worse than 20/200 in whom vision improved with a x2.5 external telescope preoperatively. The LMI was implanted after conventional phacoemulsification or microphakonit. The minimum follow-up was 6 months.

RESULTS: Six eyes of 6 patients had surgery in the worse eye. Four eyes had ARMD, and 1 eye each had myopic macular degeneration or macular dystrophy. There were no intraoperative complications. The mean gain in distance acuity was 3.66 lines +/- 1.88 (SD), and the mean increase in the Early Treatment Diabetic Retinopathy Study score for near acuity was 50.83 +/- 9.15 logMAR. The best corrected distance acuity and near acuity improved significantly (both P = .014). The mean change in endothelial count was -5.79% +/- -4.07%. The mean postoperative corneal endothelial-LMI distance was 3.15 +/- 0.31 mm. A good central fundus view was possible around the mirrors in all eyes. Fundus fluorescein angiography showed good visibility of the retina up to the midperiphery. The mean score on a quality-of-life questionnaire was 11.16 +/- 1.72 (SD) preoperatively and 4.50 +/- 0.83 postoperatively, a statistically significant improvement (P = .014).

CONCLUSIONS: The LMI may be an effective solution for optical rehabilitation of patients with ARMD or other macular pathology by increasing the central image on the retina while preserving peripheral vision. The surgery and visual recovery were quick, and the improvement in quality of life was significant.

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