SING-IMT Removal for Unsatisfied Patients: Step-by-Step Surgery for a Safe Explant

To report three cases of Smaller-Incision New-Generation Implantable Miniature Telescope (SING-IMG) explantation and three-piece acrylic intraocular lens (IOL) implantation in patients affected by late-stage dry age-related macular degeneration.

This is a single-center cohort study. Three patients with stable dry age-related macular degeneration previously implanted with SING-IMT failed to adapt to the device requesting its explantation. Surgical procedures were performed under peribulbar anesthesia, with careful removal of the SING-IMT telescope through a sclerocorneal tunnel of 8 mm and implantation of a three-piece acrylic IOL. Patients underwent pre- and postoperative assessments, including visual acuity measurements, endothelial cell count, and intraocular pressure. Patients were followed postoperatively for at least 6 months, with particular attention to IOL stability and posterior capsule integrity.

Postoperative assessments demonstrated positive outcomes, revealing no IOL dislocation or posterior capsular opacification after 6 months. Endothelial cell count diminished. Best-corrected visual acuity returned to values before SING-IMT implantation.

In our small cohort, SING-IMT explantation appeared to be a safe option. Despite promising visual outcomes, some patients might not adapt to SING-IMT. Further studies are needed to evaluate criteria to predict telescope adaptation.