Patients having both cataracts and AMD in their eyes should undergo cataract surgery using novel IOL implantation for improved vision.
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What is AMD?
AMD stands for Age-related macular degeneration. It is an eye problem concerned with the retina. It happens when a part of the retina called “macula” gets damaged. A person suffering from it loses his central vision. His eyes cannot see fine details, whether the objects are close or far. But the peripheral (side) vision of the person remains undisturbed.
There are two types of AMD:
Dry AMD:
About 80% of the patients are found to be suffering from dry AMD. When parts of the macula get thinner with age and tiny clumps of proteins called Drusen are formed, the condition is called dry AMD.
Wet AMD:
The probability of the patients to be suffering from wet AMD is less than that of dry. It is a condition when new abnormal blood vessels start growing underneath the retina. These new vessels may leak blood or some other fluid causing scarring of the macula. This condition is more serious than dry as the patient loses his vision at a faster rate in this case.
What is a Cataract?
A cataract is a condition of the eye in which the person’s eye lens becomes opaque due to the formation of some sort of cloudy layer, at the surface of the lens. A cataract begins when proteins present in the eye start forming tiny clumps that prevent the lens from sending back clear images to the retina. This leads to reduced vision and can even lead to blindness if proper treatment is not provided on time.
Most cataracts develop along with age. The ultimate treatment of cataracts is eye surgery. Surgery involves replacing the natural eye lens of the patient with an artificial IOL.
Simultaneous affect of cataract surgery and AMD
Both Cataract and AMD are serious eye problems and can pose a threat to the person’s vision. When AMD and cataract are simultaneously present in the patient’s eye, the vision further deteriorates.
Many researchers have stated their own conclusions for the effect of the progress of AMD on the patient’s eye after the cataract surgery is done. Some studies show that undergoing cataract surgery with AMD increases the progression of this condition towards a worse side of the problem. They state that the former might transform into a more advanced, vision-threatening form after the cataract surgery.
Some studies have showed that wet AMD becomes more severe after the cataract surgery. Complications such as intra-retinal cystoid changes, increased sub-retinal fluid, and macular haemorrhage, might prove difficult to deal with during the management of AMD along with cataract. The studies also mentioned the mechanism behind the rapid progress of AMD:- increased exposure to light.
On the contrary, some studies indicate that carrying out cataract surgery with the patient suffering from AMD has no negative impact on the patient’s eye health as well as the AMD also does not progress to a worse situation.
Few years back, a study was conducted considering some four thousand people to analyse the risk of carrying out cataract surgery in the presence of AMD. The study concluded that there is no clear effect of cataract surgery on the risk of progression to advanced AMD.
Another study, done on 81 eyes, concluded that cataract surgery can be safely done in patients suffering from both cataract and wet AMD. Patients with stable pre-operative fluid on OCT did well post-operatively.
Hence, there is no such study that tells the exact effect of the presence of both AMD and cataract on a person’s vision. Not paying heed to the studies telling that carrying out the cataract surgery has positive or no effect on the progression of the former is easy. But the studies that indicate a negative impact of the surgery should not be ignored.
How can the cataract surgery be carried out?
It is to be noted that providing a balanced vision to the patients suffering from both cataract and AMD is a tough task. In cataract, the visual performance of the patient is greatly reduced due to the increased opacity of the eye lens while AMD results in a significant reduction in visual activity at a later stage. Late-stage AMD seriously affects retinal health hence leading to a reduced vision. The irreparable damage to the retina caused by AMD calls for a proper, inventive solution. Thus, to improve the patient’s vision, choosing the right implant during cataract surgery is very important and further improves the patient’s vision. A novel IOL idea seems to be offering encouraging visual outcomes in AMD patients with cataract.
A study regarding this concludes that a new IOL strategy may help in increasing the eyesight in such patients. The patients who do not suffer from it show a good and speedy recovery after the cataract surgery. However, the same is not true when both cataract and AMD are found in the same patient and the surgery includes the use of normal IOLs.
To treat the patients who have both the diseases simultaneously, the use of a new IOL was analysed. This new IOL is named as iolAMD Eyemax Mono. It is a hydrophilic acrylic lens, which is used to appreciably enhance the quality of the retinal image.
A study was conducted regarding the same. It examined 122 people (244 eyes in total ) which had undergone cataract surgery and iolAMD Eyemax Mono was implanted in their eyes. The novel IOL is designed to increase the area for 10 degrees around the fovea centralis. In comparison to this new iolAMD Eyemax Mono, the standard lens provides only a 5 to 7.5 degrees of retinal eccentricity.
Surgery was done through the same, standard procedure and three surgeons were involved in the surgery. The surgery was done after giving proper anaesthesia to the patient and eye drops to dilate the pupil.
The wide-angle design of the novel IOL lens helps in controlling the blurred vision in patients with macular disorders (AMD in particular). The patients achieved a double letter distance with this new implant as compared to that achieved in the standard IOLs.
The use of novel IOL for the treatment of cataract is proven to be as safe as the use of the old standard IOL. Hence, the novel IOL provides a significant improvement in outcomes of the cataract surgery of the patients with AMD without any increase in the risk factors during the surgery.
The above study concludes that this new IOL may become a lens of choice while implanting lens during the cataract surgery in patients who simultaneously suffer from both cataract and AMD. Novel IOL can be helpful not only to the patients with both AMD and cataract but also prove helpful in improving vision in patients with cataract and other macular disorders.
Although this new IOL offers certain benefits they reduce the field of vision. It should also be noted that cataract surgery does not cure or stop the progression. It simply improves your vision.
The best way to treat your eyes is to visit your eye care professional and get your eyes checked regularly. He will be able to assess the best method of treatment for your eye ailment. Visit our website Eyemantra. To book an appointment call at +91-8851044355. Or mail us at [email protected]. Our other services include Retina Surgery, Specs Removal, Cataract Surgery, and many more.
