Hope For Cataract Patients With Macular Degeneration

Purpose: The goal of this case series is to evaluate the effect of parafoveal focusing intraocular lens in patients with macular damage. Forming a surogate macula is a complex issue, depending on structural damage, neuroadaptation, effects of the optical device.

Real life clinical setting.

Methods: A prospective evaluation of 7 subjects 10 eyes, who were preop evaluated for at least 5 years and/or treated for their macular problem. All subjects were diagnosed with visually significant cataract, that was with documented profression. They were offered cataract surgery with specially designed lens to focus on extended macular area and operated with classical phacoemulsification technique. The postoperative result was planned with 1.5 Dpt of hypeopia to achieve further image enlargement.

Results: The preoperative visual acuity was from perception of light to 0.04 (maximum 5 ETDRS letters). All surgeries were uneventful and the visual acuity increased with minimum of 4 letters for all subjects.The best result was in one bilateral case where the binocular vison was 0.4.  Subjectively all of the patioents reported improvement and increasing  independence in their everday lif,  one month after surgery. 

Conclusion: Macular deterioration is a more oftenly faced problem in ophthalmic practice today. Optical means like the aforementioned lens are a feasible option to develop a surrogate macula. The practitioners however must be aware that neuroadaptation plays a significant role and they might be patiens with limited benefits from this approach.