Enhanced Vision Outcomes With The Sing Imt™: A Case Report On Surgical Technique And Functional Gains In Late-Stage Amd

Late-stage AMD remains one of the leading causes of irreversible central vision loss in the elderly population. The introduction of intraocular magnification devices, such as the implantable miniature telescope (IMT™), has offered select patients an opportunity to regain part of their functional vision. The SING IMT™ is a second-generation prosthetic designed for monocular implantation, with a reduced incision size requirement compared to its predecessor. This report describes the 3-month postoperative results in a patient who underwent SING IMT™ implantation, evaluating both surgical feasibility and visual outcomes in comparison to preoperative predictions.

University Hospital of Brussels (UZ Brussel), Department of Ophthalmology, Belgium.

A 71-year-old female with geographic atrophy was assessed for SING IMT™ eligibility. Preoperative BCDVA was logMAR 1.42 (OD) and logMAR 1.60 (OS). Near vision was 8.0 M at 40 cm and 8.0 M at 20 cm, severely limiting functional vision. An External Telescope Simulator (ETS) evaluation confirmed at least 1 line of ETDRS gain, guiding patient selection.

Surgery was performed in OD under local anesthesia, beginning with a standard phacoemulsification cataract extraction. The primary corneal incision was enlarged to 8 mm, and the preloaded delivery system was used for controlled insertion of the SING IMT™. The three haptics were carefully positioned within the capsular bag at the 4, 8, and 12 o’clock positions. Wound closure was achieved with Nylon 10-0 sutures, using a central limited running suture and two single interrupted sutures. A standard post-cataract surgery regimen was applied.

At three months, BCDVA improved to logMAR 0.88 (OD) gaining 5 ETDRS chart lines, while near vision improved to 3.2 M at 40 cm and 2.0 M at 20 cm. Endothelial cell count remained within an acceptable range, decreasing from 2787 cells/mm² preoperatively to 2677 cells/mm² postoperatively (4% ECD loss), indicating no significant loss compared to standard cataract surgery. The patient also reported improved facial recognition, suggesting functional benefits beyond standard acuity measurements. No adverse events were found.

The SING IMT™ demonstrates safety and efficacy in this patient with late-stage AMD. The preloaded delivery system facilitated controlled implantation, contributing to corneal endothelial preservation with no significant cell loss. The observed visual improvements after 2 rehabilitation visits suggest a greater role of neural adaptation than preoperative models predict, underscoring the need for further research. Future studies should focus on long-term safety, patient selection refinement, and predictive model optimization. Importantly, the device represents a viable option for functional vision restoration, offering potential benefits for quality of life in carefully selected patients.