Download outline29674 - American Academy of Optometry

In and On the Eye Low Vision Telescopes
Eli Peli, MSc, OD
The Schepens Eye Research Institute, Mass Eye and Ear, Harvard Medical School, Boston MA
I.
On the eye telescopes
Combined Spectacle-Contact lens telescopic system
Telescopic Contact lens system (Miniscope-Feinbloom)
Recent Telescopic vision contact lens
II.
Optical concepts
Optical designs
Visual fields – impact on scotoma
Cosmetics
III.
Early implantable telescopic systems
IOL–Spectacle combination System
Donn & Koester
Alegran (Bifocal IOL system)
Morcher AMD lens (Europe)
Double bifocal IOL/Spectacle system
IV.
Current fully implantable telescopes
VIP (double IOL) system - approved in Europe
IMT Implantable Miniaturized Telescope – FDA approved
Catadioptric - Lipschitz Mirror Implant – experimental
Critical evaluation of all these systems
V.
IMT surgical procedure
The operation
Recovery and post operative care
Care team OD, MDs (cataract and retinal), Rehabilitation teacher/trainers
VI.
Modes of use
Intermittent vs. constant use
Bilateral vs. Monocular implant
Bi-ocular multiplexing
Eye dominance consideration
Partial occlusion
VII.
Clinical studies
VIP – clinical, optical analysis
Catadioptric report
IMT
European study
Phase 1 USA FDA safety study
Phase II/III FDA pivotal study
UK study
VIII. Optical advantages of implantable telescope
Dynamic vision: head and eye movements
Vestibular effects and bi-ocular differences
Comparison with competing technologies
Depth perception
Monocular parallax enhancement
IX.
Light loss in Implantable telescopes
Light economy of telescopes
Light adaptation and its role
X.
Glare
Possible sources
Controls current and developments
Clinical solution
XI.
Summary and Conclusion
XII. References
1.
Choyce, P. Galilean telescope using the anterior chamber implant as an eye-piece: a low visualacuity aid for macular lesions, Intra-Ocular Lenses and Implants, London: H.K. Lewis & Co. 156-161.
(1964).
2.
Willis, T. R. & Portney, V. Preliminary evaluation of the Koziol-Peyman teledioptric system for
age-related macular degeneration. European Journal of Implant and Refractive Surgery, 1, 271-276. (1989).
3.
Koziol, J. E., Peyman, G. A., Cionni, R., Chou, J. S., Portney, V., Sun, R. & Trentacost, D..
Evaluation and implantation of a teledioptric lens system for cataract and age-related macular degeneration.
Ophthalmic Surgery, 25, 675-684. (1994)
4.
E. Peli, I. Lipshitz and G. Dotan, "Implantable miniaturized telescope (IMT) for low vision.," in
Vision Rehabilitation: Assessment, Intervention and Outcomes C. Stuen, A. Arditi, A. Horowitz, M. A.
Lang, B. Rosenthal and K. Seidman, Eds., pp. 200-203, Swets & Zeitlinger, Lisse (2000).
5.
Kaskaloglu, M., Uretmen, O. & Yagci, A. (2001). Medium-term results of implantable miniaturized
telescopes in eyes with age-related macular degeneration. Journal of Cataract and Refractive Surgery, 27,
1751-1755. (2001)
6.
E. Peli The optical functional advantages of an intraocular low vision telescope. Optometry and
Vision Science 79: 225-233 (2002).
7.
H. L. Hudson, S. S. Lane, J. S. Heier, R. D. Stulting, L. Singerman, P. R. Lichter, P. Sternberg and
D. F. Chang, "Implantable miniature telescope for the treatment of visual acuity loss resulting from endstage age-related macular degeneration: 1-year results," Ophthalmology 113(11), 1987-2001 (2006)
8.
Cakmakci, O. & Rolland, J.. Design and fabrication of a dual-element off-axis near-eye optical
magnifier. Optics Letters, 32, 1363-1365. (2007)
9.
Orzalesi, N., Pierrottet, C. O., Zenoni, S. & Savaresi, C. The IOL-Vip System: a double intraocular
lens implant for visual rehabilitation of patients with macular disease. Ophthalmology, 114, 860-865.
(2007).
10.
Hudson, H. L., Stulting, R. D., Heier, J. S., Lane, S. S., Chang, D. F., Singerman, L. J., Bradford, C.
A. & Leonard, R. E. (2008). Implantable telescope for end-stage age-related macular degeneration: longterm visual acuity and safety outcomes. American Journal of Ophthalmology, 146, 664-673. (2008)
11.
Agarwal, A., Lipshitz, I., Jacob, S., Lamba, M., Tiwari, R., Kumar, D. A. & Agarwal, A. Mirror
telescopic intraocular lens for age-related macular degeneration: design and preliminary clinical results of
the Lipshitz macular implant. Journal of Cataract and Refractive Surgery, 34, 87-94. (2008).
12.
Amselem, L., Diaz-Llopis, M., Felipe, A., Artigas, J. M., Navea, A. & Garcia-Delpech, S. Clinical
magnification and residual refraction after implantation of a double intraocular lens system in patients with
macular degeneration. J Cataract Refract Surg, 34, 1571-1577. (2008).
13.
Primo, S. A. Implantable miniature telescope: lessons learned. Optometry, 81, 86-93. (2010)
14.
Tremblay, E. J., R. D. Beer, et al.. Telescopic vision contact lens. Ophthalmic Technologies XXI,
San Francisco, CA, SPIE. (2011)
15.
Singer MA, Amir N, Herro A, Porbandarwalla SS, Pollard Improving quality of life in patients with
end-stage age-related macular degeneration:focus on miniature ocular implants Clinical Ophthalmology:6
33–39 (2012)