In Vivo Evaluation of SING IMT™ Alignment for Late-Stage Age-Related Macular Degeneration Using Anterior Segment OCT

This study aimed to assess the in vivo positioning, tilt, and decentration of the second-generation implantable miniature telescope (SING-IMT™; Samsara Vision, Inc., Far Hills, NJ, USA) using swept-source anterior segment optical coherence tomography (AS-OCT).

This was a multicentric retrospective observational study conducted at two tertiary referral centers (Palagi Hospital, Florence, Italy, and Royal Victoria Infirmary Hospital, Newcastle upon Tyne, UK). Eleven eyes from 11 patients with end-stage age-related macular degeneration (AMD) underwent secondary SING IMT™ implantation at these two tertiary centers. Using high-resolution AS-OCT (CASIA2 system [Tomey, Nagoya, Japan] and Anterion system [Heidelberg Engineering, Heidelberg, Germany]), telescope alignment was assessed after 12 months. Decentration and tilt were calculated and reported in both Cartesian and polar coordinates. Telescope configuration relative to the iris plane and corneal-telescope (C-T) distance and endothelial cell count was also evaluated.

The mean (± standard deviation) follow-up was 15.7 ± 2.8 months. The mean decentration was 0.33 ± 0.12 mm, with a predominant superior and nasal displacement. Mean tilt was 3.28 ± 1.31°, oriented mainly in the supero-temporal direction. Three positional configurations were observed: anterior to the iris plane (36.4%), at the iris plane (36.4%), and posterior to the iris plane (27.3%). The mean C-T distance was 2.71 ± 0.48 mm. Mean endothelial cell loss at 12 months was 13.21% ± 3.57%.

After 12 months of follow-up, the SING IMT™ maintained stable in-the-bag fixation, with tilt and decentration values within the ranges previously reported for conventional in-the-bag intraocular lenses.