The IOL-Vip System: A Double Intraocular Lens Implant for Visual Rehabilitation of Patients with Macular Disease
Presented in part at: Association for Research in Vision and Ophthalmology annual meetings, April 2004 and April 2006 (poster session), Ft. Lauderdale, Florida.
Received 14 July 2005; accepted 22 November 2006.
Purpose
To investigate the efficacy of a new surgical and rehabilitative procedure designed to improve vision in patients with central scotoma due to macular diseases.
Design
Case series of 40 consecutive surgical and rehabilitative procedures.
Participants
Forty eyes of 35 consecutive patients with a stable central scotoma due to macular disease underwent phacoemulsification cataract surgery with the implant of the IOL-Vip System.
Methods
The IOL-Vip System consists of a biconcave high minus-power intraocular lens (IOL) in the capsular bag and a biconvex high plus-power IOL in the anterior chamber, reproducing an intraocular Galilean telescope with ×1.3 magnification for distance. Selection of the candidate patients was carried out by means of a low-vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates the residual visual function of patients and prognosis for visual improvement based on simulation of the postoperative condition. The software also designs the rehabilitation strategies based on preoperative and postoperative training of the preferred retinal locus.
Main Outcome Measures
Best-corrected visual acuity (BCVA), evaluated by means of the Early Treatment Diabetic Retinopathy Study charts and procedure; reading magnification; and reading distance.
Results
All patients showed an improvement of visual acuity (VA) due to the surgical and rehabilitative procedure, confirming or exceeding the preoperative expected results. Mean postoperative BCVA was 0.77 (logarithm of the minimum angle of resolution), compared with 1.28 preoperatively. The mean postoperative best reading magnification gain was ×6.2, and the mean postoperative reading distance gain was 7.66 cm. No cases of intraoperative or postoperative complications were detected, and the implant was subjectively well tolerated in both monocular and binocular procedures.
Conclusion
In this pilot study, the IOL-Vip System was shown to be effective and apparently well tolerated in improving the vision of patients with macular disease. Best-corrected VA, reading magnification, and reading distance improved in all cases of this low-vision patient series.
1University Eye Clinic, San Paolo Hospital, Milan, Italy.
3Ophthalmology Department, Clinica Santa Rita, Milan, Italy.
Correspondence and reprint requests to Nicola Orzalesi, Eye Clinic Director, University of Milan, San Paolo Hospital, Via A. di Rudinì 8, 20142 Milan, Italy.
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