Mirror telescopic intraocular lens for age-related macular degeneration: design and preliminary clinical results of the Lipshitz macular implant.
OBJECTIVE
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
Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.


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.
Agarwal
Amar
A
Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. dragarwal@vsnl.com
Lipshitz
Isaac
I
Jacob
Soosan
S
Lamba
Mandeep
M
Tiwari
Rahul
R
Kumar
Divya A
DA
Agarwal
Athiya
A
D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008268:Macular Degeneration / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D017060:Patient Satisfaction; D018918:Phacoemulsification; D010865:Pilot Projects; D011446:Prospective Studies; D011474:Prosthesis Design; D011788:Quality of Life; D011795:Surveys and Questionnaires; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014786:Vision Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology