Experiences with the Scharioth Macula Lens - new hope for patients with dry macular degeneration

Objective (aim): Age-related macular degeneration (AMD) is the main cause of visual impairment in developed countries among the elderly. Our aim was to share our experiences with an implant designed to help improve near vision of patients with the non-exudative form of the disease. Methods: 15 pseudophakic patients suffering from dry type AMD, who had been implanted with the Scharioth Macula Lens (A45SML; Medicontur, Hungary), were included in the retrospective study. Prospective visual improvement was tested preoperatively, using the method recommended by the manufacturer: improvement in near visual acuity with +2.5D compared to +6.0D addition. Follow-up period was three months. Using pre- and postoperative data, changes in near and distance visual acuity, and the correlation between the predicted and achieved improvement were evaluated. Results: Preoperative corrected near vision with +2.5D and +6.0D addition was 0.17±0.07, and 0.36±0.11, respectively. Uncorrected near visual acuity 3 months postoperatively was 0.46±0.16. Predicted and actual visual improvement was 3.5 and 4.4 lines, respectively. No significant change in either the uncorrected or the best-corrected distance vision could be observed three months postoperatively. Neovascularization occurred three months postoperatively in one patient who had had stabilized wet macular degeneration before. Following treatment, the visual acuity returned to the sixth week level. Conclusions: The preoperative test is a reliable tool to predict the effectiveness of the implant. Our results suggested that the SML significantly improves near visual acuity without affecting distance vision; therefore, the SML can be an effective method to ameliorate the quality of life for these patients. Abbreviations: AMD = Age-Related Macular Degeneration, anti-VEGF = Anti-Vascular Endothelial Growth Factor, AREDS = Age-Related Eye Disease Study, BCDVA = Best Corrected Distance Visual Acuity, CNVA = Corrected Near Visual Acuity, ETDRS = Early Treatment Diabetic Retinopathy Study, IOL = Intraocular Lens, SML = Scharioth Macula Lens, T2.5 = Corrected Near Visual Acuity at 40 cm with an addition of +2.5 D, T6.0 = Corrected Near Visual Acuity at 15 cm with an addition of +6.0 D, UCDVA = Uncorrected Distance Visual Acuity, UCNVA = Uncorrected Near Visual Acuity.