Eyeworld

EW CATARACT 31 November 2018 to the Early Treatment Diabetic Ret- inopathy Study. The mean preop- erative corrected near visual acuity (CNVA) for 33 centimeters distance improved from 1.36 logMAR to 0.88 logMAR postoperatively (p<.0001). "The wide-angle design of the implant is effective in controlling peripheral blur in eyes with mac- ular disease. We have done several studies using this novel IOL and the gain in letters for distance is roughly double of that achieved through the implantation of standard IOLs in these patients," Dr. Artal said. "My own experience with a small group of 15 patients was that this IOL received positive feedback from patients, however, the patients were selected for implantation and were in early stages of AMD, with baseline visual acuity of no lower than 0.3/0.4 logMAR. Patients with lower visual acuities have even high- er expectations, and although this device is useful, it does not perform miracles." Dr. Artal observed that out- comes using this IOL or any tele- scopic, magnifying device were largely dependent on the degree of AMD and that it was important for AMD patients to understand their own expectations. "Cataract surgery with standard IOL provides a modest benefit, and it is important to remember that surgeons should avoid the implantation of diffractive lenses if they opt for standard IOLs because they reduce contrast. Other options include large, telescopic implants that require special, more complicated surgeries, which should be reserved for advanced AMD cases. When the visual field is reduced, you need to balance that with the benefits of magnifying IOLs because magnifying IOLs reduce the field of vision. Finally, AMD patients should understand that when you are doing any type of cataract surgery, you are helping them, but in a way, they are buying time. The macular disease will progress, and doing a cataract intervention is not curing the retinal disease. Many patients are not going to understand this. The iolAMD is a promising area. I think there are going to be more innovations like this coming in the future." EW References 1. Qureshi MA, et al. Consecutive case series of 244 age-related macular degeneration patients undergoing implantation with an ex- tended macular vision IOL. Eur J Ophthalmol. 2018;28:198–203. Editors' note: Dr. Artal has financial interests related to his comments. Contact information Artal: loum@um.es

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