Multifocal IOL and AMD

A new multifocal intraocular lens (IOL) could provide a new way to help patients with macular disease maintain daily functioning with less dependence on low vision aids, reported Gerd Auffarth MD, University of Heidelberg Eye Clinic, Germany, at the 2015 American Society of Cataract and Refractive Surgery Symposium in San Diego, USA.

Dr Auffarth reported his very early experience with the LENTIS Mplus High Add IOL in eight age-related macular degeneration (AMD) patients being treated for cataract. The lens is an aspheric multifocal IOL with a biconvex optic that includes a sector-shaped near addition. Its overall length is 11.0mm, with a 6.0mm optic. With a 8.00D near addition, this IOL has the potential to be very useful in patients with AMD because it translates to 6.00D of near correction on the spectacle plane, providing 1.5 times magnifying power, he explained.

The eight patients were all more than 60 years old with wet AMD. All had stable disease and most had received multiple courses of anti-VEGF therapy. The patients had cataracts and received the IOL in one eye only. The CE approved lens is implanted with standard techniques in the capsular bag.

SIGNIFICANT IMPROVEMENTS

The early experience was very positive, with all patients showing significant improvements in functional activities such as cooking, handwriting and reading. Patients were able to reduce or eliminate their reliance on low vision loupes. In addition, perhaps because of the nature of the retinal disease, patients reported no problems whatsoever with glare or halos. “Before surgery these patients needed 15x magnification or 20x magnification using cumbersome low vision aids. At 12 months the same patients could read newspapers and perform the daily activities that allowed them to live independently without low vision aids,” said Dr Auffarth.

One patient, a 68-year-old woman, presented with a central macular scar in one eye and AMD in the other. Before receiving the IOL she required 15x magnification in order to read. She received a 20.5D lens. At 12 months her distance vision improved from 0.1 decimal to 0.3, but her near visual acuity improved to 0.4, good enough to read a newspaper. “We don’t expect to see much improvement in distance because of the nature of the lens and the disease. But the near visual acuity improvement is quite a big thing for this patient,” he added.

Gerd Auffarth:

gerd.auffarth@
med.uni-heidelberg.de