Treatments for Dry Macular Degeneration are available at
The IOL VIP Procedure
After detailed assessment and discussion, patients choosing to
go ahead with the procedure are usually offered surgery for their
better seeing eye.
A YAG laser iridotomy is done in the clinic a few days before
the operation, which creates a small opening in the iris. The
surgery is usually done under a local anaesthetic as a day case
procedure, with post-operative drops required for a month.
In the procedure, two lenses are placed in the eye. Following
lens removal, as done for cataract surgery, a concave intraocular
lens is placed within the capsular bag, acting as the ocular piece
of a telescope; and a convex lens is placed in front of the iris in
the anterior chamber, acting as the objective lens in a
This system thus creates a Galilean Telescope in the eye,
offering a magnification of 1.3x. By rotating the two lenses a
prismatic effect is also induced, allowing the patient to use an
eccentric preferred retinal locus to maximise vision.
The potential improvement in vision can be tested using a
simulator, enabling the surgeon to select patient who are most
likely to benefit, and at the same time giving patients an
opportunity to experience the potential improvement in their vision
before undergoing the operation.
Customised software is used to map the patients PRL (preferred
retinal locus), and plan placement of the lenses to exploit this to
the best advantage. The Milan team have published their initial
results and have now implanted hundreds of patients with very
encouraging results. Many patients recover their ability to perform
daily activities such as reading as well as watching television,
recognising money and sewing.
Why use the IOL -VIP system?
The low optical magnifying power of the IOL-VIP system allows
the maintenance of the peripheral visual field and possibility of
comfortable binocular vision, thus making it suitable for monocular
or binocular implantation. The improvement in distance VA reduces
the amount of magnification needed for near vision, which leads to
better and more comfortable reading.
This is also favoured by the increased reading distance, which
helps to satisfy the aim of making IOL-VIP-implanted eyes similar
to those of people with normal sight. I have had training for the
procedure and have been very impressed with the system and its
Will this work for all patients with Dry AMD?
Patients with moderate visual loss are most likely to
Generally patients with 6/18 or worse vision in both eyes and at
least 6/60 or better in one eye are good candidates for this
system. Patients with pre-existing endothelial guttata and those
with high refractive errors are not offered this procedure.
Patients with diseases which compromise the visual field, such
as glaucoma are also excluded.
This procedure is not suitable for all patients with Dry AMD,
but it does offer potential significant benefits to some patients
with Dry AMD.
What are the risks of the procedure?
The risks of the procedure are similar to that of cataract
surgery. These include a rare risk of infection (less than 5 in a
1000), and other risks such as bleeding. As for cataract surgery
these risks are rare and can usually be managed effectively.
Endothelial cell loss is slightly higher, but this should not be
a problem for the majority of patients as anyone with signs of
endothelial compromise pre-operatively is excluded.
Full details of risks and benefits are discussed with the
patient before proceeding with the procedure.
For more information contact our Enquiry Handling team on