Enhancing the quality of life in visually impaired AMD patients

Article

An analysis of the AcrySof ReSTOR apodized diffractive intraocular lens

For many years we have induced pseudophakic myopia of 5 dioptres in our age-related macular degeneration (AMD) patients. This helped aid in near vision recovery and allowed patients to resume some activities in their lives that they were unable to previously do as a result of poor vision. It also avoided spectacle induced loss of contrast sensitivity. While our patients were pleased with their near acuity, they were displeased with the high myopic correction for distance acuity.

Low vision aid

While the lens is not indicated for this use, I realized that I could use the lens as a low vision aid. Under photopic conditions, a -2.00 distance refraction provides a near equivalent of +5.20 D with a best focus of 20 cm. The AcrySof ReSTOR lens technique does not reduce uncorrected distance acuity nearly as much as a -5.0 D myopia inducing monofocal lens. The patients were much happier now that they only needed a -2.0 D distance correction.

Our first two AMD patients that were implanted with the ReSTOR lens were absolutely ecstatic, so we started a pilot study. The pilot study was a prospective series of cataract patients with vision loss from AMD, who received an offlabel AcrySof ReSTOR IOL following phacoemulsification. Surgery was planned for a desired postoperative refraction of -2.0 to -3.0 spherical equivalent. This pilot study also demonstrated that not only was the patients' uncorrected near acuity improved, but also that many aspects of their quality of life improved; therefore a formal, multicentre study was conducted.

The 6-month multicentre included 20 eyes of 13 patients that were more than 50 years of age with stable, dry macular degeneration or with macular degeneration associated with disciform scarring per the doctor's examination. Near and distance Snellen visual acuities with and without correction were collected, as well as subjective patient quality of life statements collected pre and postoperatively. The National Eye Institute Visual Function Questionnaire (VFQ-25 Version 2000) was also administered to the patient's pre- and postoperatively.3

Related Videos
ARVO 2024: Andrew D. Pucker, OD, PhD on measuring meibomian gland morphology with increased accuracy
 Allen Ho, MD, presented a paper on the 12 month results of a mutation agnostic optogenetic programme for patients with severe vision loss from retinitis pigmentosa
Noel Brennan, MScOptom, PhD, a clinical research fellow at Johnson and Johnson
ARVO 2024: President-elect SriniVas Sadda, MD, speaks with David Hutton of Ophthalmology Times
Elias Kahan, MD, a clinical research fellow and incoming PGY1 resident at NYU
Neda Gioia, OD, sat down to discuss a poster from this year's ARVO meeting held in Seattle, Washington
Eric Donnenfeld, MD, a corneal, cataract and refractive surgeon at Ophthalmic Consultants of Connecticut, discusses his ARVO presentation with Ophthalmology Times
John D Sheppard, MD, MSc, FACs, speaks with David Hutton of Ophthalmology Times
Paul Kayne, PhD, on assessing melanocortin receptors in the ocular space
Osamah Saeedi, MD, MS, at ARVO 2024
© 2024 MJH Life Sciences

All rights reserved.