gms | German Medical Science

Purpose: To evaluate visual and microperimetry changes in eyes with macular diseases implanted with the EyeMax Mono (SharpView Ophthalmology, London, UK) intraocular lens (IOL).

Methods: This retrospective, real-world case series included patients with macular disease who underwent cataract extraction and implantation of the EyeMax Mono IOL. Assessments comprised refraction, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography, and microperimetry. Outcome measures included spherical equivalent (SE), logMAR corrected distance visual acuity (CDVA), and microperimetry parameters, such as fixation stability and bivariate contour ellipse areas (BCEA 63% and BCEA 95%), recorded at baseline and the final follow-up (up to 12 months).

Results: This study included 21 eyes from 11 patients with a mean age of 72.8±8.3 years and followed for a mean 7.38±4.03 months. Preoperatively, geographic atrophy (GA) measured 4.7±4 mm² (n=14), while ellipsoid zone (EZ) loss on horizontal SD-OCT was 2,433.1±1,009.5 µm (n=17). At the final follow-up, spherical equivalent (SE) was +1.50 D ± 1.00 D (n=19). CDVA improved from 0.79±0.33 to 0.59±0.34 (p=0.004, n=21), with 12 eyes gaining at least one line and 7 of those improving by =3 lines. Pre- and postoperative BCEA 63% and BCEA 95% changed from 8.4±7.2 to 6.7±4.9 (p=0.33) and from 22.9±21.1 to 20.1±14.6 (p=0.73), respectively (deg²; n=15). Fixation stability improved in 2 eyes, remained unchanged in 9, and worsened in 4. A higher preoperative BCEA values correlated with greater postoperative improvement (r>0.6; p<0.01). In the extrafoveal fixation group (n=11), 55% and 45% demonstrated improvements in BCEA 63% and BCEA 95% respectively, while 64% showed improvement in CDVA.

Conclusions: Implantation of EyeMax Mono IOL improved CDVA by 2 lines and microperimetry in half of the patients, with better outcomes observed in eyes with extrafoveal fixation (worse initial BCEA). We hypothesize that the IOL’s optical design, rather than cataract removal alone, accounts for the observed microperimetry changes, although the cohort may not be statistically powered to reach statistical significance.