Clinical magnification and residual refraction after implantation of a double intraocular lens system in patients with macular degeneration.
OBJECTIVE
To evaluate the efficacy of a standard double intraocular lens (IOL) system (IOL-Vip) in patients with low vision and central scotoma due to macular degeneration and assess the predictability of the residual refraction and magnification.


METHODS
Ophthalmology Department, Hospital General Universitario, Valencia, Spain.


METHODS
This interventional prospective noncomparative case series comprised 13 consecutive surgical procedures in 10 patients with central scotoma. Follow-up was 12 months. Evaluation included the difference between preoperative and postoperative best corrected visual acuity (BCVA), refraction, position of the IOLs, endothelial cell density, and occurrence of postoperative complications. Residual refraction and eye magnification were calculated using a theory developed in a previous study, and the values were compared with the clinical results.


RESULTS
The mean BCVA was 1.37 logMAR preoperatively and 0.68 logMAR 1 year postoperatively. The mean best corrected clinical gain was 44%. There was no statistically significant difference between the clinically evaluated and theoretically calculated residual refractions (P = .17). No intraoperative or postoperative complications occurred.


CONCLUSIONS
Implantation of the double IOL system improved BCVA in patients with low vision due to advanced maculopathy. The results were best in myopic patients (long eyes); patients with hyperopia (short eyes) had high residual refraction. The postoperative clinical gain and residual refraction were predictable, showing the feasibility of implanting a customized double IOL.
Amselem
Luis
L
Hospital General Universitario, Departamento de Optica, Facultad de Física, Universitat de València, C/Dr Moliner 50, Burjassot, Valencia, Spain.
Diaz-Llopis
Manuel
M
Felipe
Adelina
A
Artigas
Jose M
JM
Navea
Amparo
A
García-Delpech
Salvador
S
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology*; D012607:Scotoma / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D015354:Vision, Low / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*