Ultrasound Biomicroscopy of an Implantable Miniaturized Telescope

Age-related macular degeneration (ARMD) is a leading cause of visual loss in adults older than 60 years.¹ Once central vision has been seriously jeopardized, visual function can only be improved with optical devices that produce magnification of near and distant images. Koziol et al² reported the use of a teledioptric lens implant with a high-minus central zone (2.5 mm). When this implant is used in combination with eyeglasses as part of a teledioptric system, the magnified visual field obtained is 2.6 times greater than that achieved using an external telescope (magnification power, ×3; focusing distance, 50 cm; magnification power with the aid of external spectacles, ×8; visual field, 6, 6° equivalent to 20° in the retina). However, the disadvantages found when a combined telescopic system is used still occur. The implantable miniaturized telescope (IMT) (VisionCare Ophthalmic Technologies Ltd, Yehud, Israel) designed by Lipshitz et al³ should partially prevent the discomfort involved when an external or partially external telescope is used. The IMT is mounted on an intraocular lens implant and consists of a glass Galilean telescope (4.4 mm long and 3.2 mm in diameter) installed in a hole centered in a plate-design polymethyl methacrylate intraocular lens (7.0 × 4.75 mm) (Figure 1). The total diameter of the device is 13.5 mm. Implantation of the IMT is performed by widening up to 8 mm the incision after lens phacoemulsification with scleral incision and capsulorrhexis, which theoretically ensures the intracapsular implantation and thus stability and adequate position of the IMT.