Prospective Visual Outcomes After Extended Macular Vision Iol Implantation And Structured Rehabilitation In Late-Stage Age-Related Macular Degeneration

To evaluate the visual and functional outcomes of an extended macular vision intraocular lens (EyeMax Mono IOL; Sharpview Ophthalmology) implantation followed by structured visual rehabilitation in patients with central vision loss due to late-stage age-related macular degeneration (AMD).

Single-center, prospective case series

This case series included eyes with stable late-stage AMD that underwent unilateral phacoemulsification with EyeMax Mono IOL implantation. Postoperatively, patients received 4–6 biweekly visual rehabilitation sessions starting one month after surgery. Functional assessments included logMAR best-corrected distance and near visual acuity (CDVA; CNVA), reading speed (words per minute, WPM), mean retinal sensitivity and fixation stability (bivariate Contour Ellipse Area; BCEA) as measured by MP-3 microperimetry at baseline and 6 months postoperatively. Patients also completed a questionnaire assessing subjective visual function and quality of life at both timepoints.

Eleven eyes from 11 AMD patients, aged 72.6±9.1 years, with LOCSIII grade 2-3 cataracts were included. At 6 months, CDVA improved significantly from 1.2±0.2 to 0.75±0.26 logMAR (p=0.004), gaining 21±12.5 ETDRS letters. CNVA improved from 0.99±0.3 to 0.6±0.2 (p=0.002). Reading speed increased from 26.3±18.4 to 41.2±20.1 WPM (p=0.004). Fixation stability improved significantly (BCEA: 6.6±8.4°² to 3.4±3.2°²; p=0.019); one patient improved from unstable to stable fixation and no patient deteriorated. Mean retinal sensitivity remained unchanged (p=0.35). No patient lost CDVA lines; one lost 0.04 logMAR CNVA. Patient-reported outcomes showed significant improvements in patient satisfaction and various activities (all p≤0.03).

The implantation of EyeMax Mono, combined with visual rehabilitation, significantly enhanced functional vision and satisfaction in patients experiencing central vision loss due to late-stage AMD. The observed improvements in visual acuity, reading performance, and fixation stability suggest that the extended macular vision optics of the EyeMax Mono provide functional benefits beyond those achievable with cataract extraction alone.