Enhancing Functional Vision And Quality-Of-Life In Advanced Amd: Six-Month Outcomes Of The Smaller-Incision New-Generation Implantable Miniature Telescope (Sing Imt™)

To evaluate the short- and mid-term anatomical and functional outcomes of Smaller-Incision New-Generation Implantable Miniature Telescope (SING IMT™) implantation in patients with advanced age-related macular degeneration [AMD, geographic atrophy or macular neovascularization (MNV) scar], involving bilateral foveal damage and visually significant cataract.

Single-center, retrospective, observational study conducted in a tertiary ophthalmology referral center.

16 patients with bilateral advanced AMD and cataract who underwent SING IMT™ implantation with a minimum follow-up of 6 months were included. Device implantation followed standard phacoemulsification via limbal or scleral tunnel approach. Preoperative and postoperative assessments (day 1; week 1; months 1, 3, and 6) included slit-lamp and dilated fundus examination,macular lesion subtype,corrected distance and near visual acuity (CDVA, CNVA), LVQoL (Low Vision Quality of Life) scores, manifest refraction, anterior chamber depth,keratometry,endothelial cell parameters,intra- and postoperative complications. A structured 6-month postoperative visual rehabilitation program was implemented to enhance binocular integration and functional vision.

Mean age was 71.2±6.1 years (n=16). Mean CDVA improved from 1.07±0.18 logMAR preoperatively to 0.79±0.15 at 6 months (p=0.001). A ≥0.1 logMAR (≥5 ETDRS letters) gain was achieved in 81.3% (13/16). Near vision improved markedly: no patient achieved ≥1.0 logMAR preoperatively, compared with 100% at 3 and 6 months. Mean CNVA at 6 months was 0.58±0.12 logMAR. LVQoL scores improved significantly (p<0.001), with ≥10-point gain in 81.3%. Endothelial cell density decreased by 11.0%±7.6% (p<0.001). Transient IOP rise (25%) and corneal edema (18.8%) were the most common early complications; late complications included iris atrophy (18.8%) and device dislocation (6.2%). No MNV reactivation was observed and, no patient required SING IMT™ explantation.

SING IMT™ implantation in advanced AMD provided clinically meaningful improvement in distance and near visual acuity, with significant enhancement in vision-related quality of life. Functional improvement became more pronounced after 3 months, consistent with the expected visual rehabilitation and neuroadaptation process, and remained stable through 6 months. Despite a measurable endothelial cell decrease, adverse events were manageable under close postoperative follow-up. The procedure appears to be an effective rehabilitative option in carefully selected patients with advanced AMD and coexisting cataract.