Aqueous infiltration into an implantable miniaturized telescope

The implantable miniaturized telescope (IMT) is the first intraocular magnifying system proposed for optical correction in patients with age-related macular degeneration (ARMD). The optical component is embedded in a carrying device designed as an intraocular lens that is implanted after cataract surgery. In this study, we report findings on an IMT that was explanted because of aqueous infiltration into its optic and describe the configuration of this device and the surgical technique required for its implantation. The patient, a 75-year-old male with bilateral cataract and nonexudative ARMD, underwent phacoemulsification with implantation of an IMT in the right eye. The rigid device, weighing 46.1 mg in aqueous, has an overall diameter of 13.5 mm and requires implantation through a large limbal incision. It is fixated at the 6 to 12 o'clock meridian. Follow-up examination revealed the presence of numerous droplets inside the IMT optic. The device was explanted and sent to our center for evaluation. A large fissure was found on the carrying device. However, it was unlikely the site for aqueous infiltration. Microdefects at the level of the sealing of the optical cylinder appeared to provide the opening for the inflow of aqueous that formed droplets. Based on the findings of this report the manufacturer has modified the sealing technique to avoid this complication. Current clinical trials are now ongoing to assess the efficacy of this device in providing visual rehabilitation for ARMD patients.