Author: Jana Nekolova (Czech Republic)
Co-authors: Jan Kremlacek, Jiri Lukavsky, Radovan Sikl, Jana Langrova, Jana Szanyi, Nada Jiraskova
Purpose
Age-related macular degeneration (AMD) is a leading cause of visual impairment in elderly patients. The disease still leads to a progressive central visual loss, and disturbs activities requiring recognizing details. Macular degeneration has a deep negative impact on the quality of life and disables patients in performing their daily activities.
Setting/Venue
Setting/Venue: Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of medicine, Charles University, Hradec Kralove, Czech Republic; Department of Pathological Physiology and Department of Biophysics, Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic; Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic; Institute of Psychology, Czech Academy of Sciences, Prague, Czech Republic
Methods
Patients with non-active AMD were included in the project. The low-vision implant, the Scharioth Macula Lens (SML) was implanted into their better seeing eye. Intensive everyday visual rehabilitation was performed for four weeks, from the second day after surgery. The quality of life before SML implantation and visual rehabilitation and 6 month after was measured using vision function questionnaires; NEI-VFQ (National Eye Institute Visual Functioning Questionnaire) and a questionnaire based on MacDQoL (Macular Disease Quality of Life) with modification for the purpose of this study (modif.MacDQoL). The near VA was measured using paragraphs of text size increasing from 0.37 mm to 2.5 mm (the Jaeger chart) and distant vision was tested using electronic optotypes.
Results
There were 20 patients included in the study. Results of 10 patients were analyzed. Comparing preoperative data of NEI-VFQ with postoperative, seven participants marked their general health as stable, two worse and one better. General vision remains unchanged in 3 of 10, 6 patients rated their general vision after implantation as better than before. Near vision improved in all participants. Also mental health was better rated 6 month after surgery. The modif.MacDQoL questionnaire survey showed that in the vast majority of patients (n=9) the positive effects of intervention outweighed the demands of the procedure; only one complained of worse reading 6 months after surgery. Six months after SML implantation, central retinal thickness was 166.8 (99-215) micrometres, best corrected VA of implanted was 0.17 (0.1-0.3), and uncorrected near visual acuity was approximately J.T.4 (1-8). There were no severe complications during surgery and postoperatively.
Conlusions
An implantation of an add-on bifocal aspheric lens, with unmagnified periphery and an addition of +10 diopters in the central portion 1.5 mm in diameter, the SML, followed by rehabilitation improves near vision and increases patients´ happiness and satisfaction. Financial Disclosure: The project is supported by the grant AZVMZ CR NV18-06-00484
Financial Disclosure
The project is supported by the grant AZVMZ CR NV18-06-00484
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