Intraocular Lenses in the Treatment of Macular Diseases Affecting the Fovea

Introduction: Age related macular degeneration is the leading cause of legal blindness in the developed world. Currently no treatments exist for the majority of patients that suffer from this disease with injections only available to slow the advanced form of the disease. Patients can be offered various external devices above and beyond corrective glasses, however these are cumbersome and often compliance is very low. Age related macular degeneration is just one of many diseases that affect the macula and the fovea, all these diseases often share the fact that the central visual field is severely diminished. Implantable telescopic devices have been designed hat can be placed within the eye itself with the function of magnifying images on the retina and deflecting the image produced away for the diseased macula and fovea. Methodology: PUBMED searches were used to discover all of the published trials using these intraocular telescopic devices. OF the many terms searched and found it was discovered that there were 4 separate trials using different designed lenses and different treatment protocols. These 4 were compared and contrasted. Results: All 4 trials showed improvement in patients’ post-operative visual acuity when compared to before. Complications of either the procedure or the follow up of the patient were not reported in 3 of the trials, and in the remaining trial severe complications were extremely rare. 3 trials did report significant loss of peripheral vision after implantation. Certain trials placed more emphasis than others on pre implantation software analysis and post implant rehabilitation and it is likely that these components play as large a factor in the success of the treatments as the design of the intraocular telescopic device itself. The best results did appear to come when there had been the most extensive post-operative rehabilitation however due to the intensive nature of the program patient compliance and satisfaction with the scheme was low. Conclusion: The post-operative visual acuity was improved in all patient groups up to a year after operation. The downside is that the degree of peripheral visual field loss and time consuming rehabilitation mean that patient satisfaction is not yet optimal. However given the elderly nature of these patients and their difficulty in preforming simple activities of daily living these significant improvements in visual acuity are extremely helpful with watching television or reading and thus improving quality of life.