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  • Title: Implantable vision-enhancing devices and postoperative rehabilitation in advanced age-related macular degeneration.
    Author: Borkenstein AF, Borkenstein EM, Augustin AJ.
    Journal: Eye (Lond); 2023 Mar; 37(4):597-606. PubMed ID: 35869389.
    Abstract:
    Age-related macular degeneration (AMD) results in progressive vision loss that significantly impacts patients' quality of life and ability to perform routine daily activities. Although pharmaceutical treatments for AMD are available and in clinical development, patients with late-stage AMD are relatively underserved. Specialized rehabilitation programs and external low-vision aids are available to support visual performance for those with advanced AMD; but intraocular vision-improving devices, including implantable miniature telescope (IMT) and intraocular lens (IOL) implants, offer advantages regarding head motion, vestibular ocular reflex development, and depth perception. IMT and IOL technologies are rapidly evolving, and many patients who could benefit from them remain unidentified. This review of recent literature summarizes available information on implantable devices for improving vision in patients with advanced AMD. Furthermore, it discusses recent attempts of developing the quality of life tests including activities of daily life and objective assessments. This may offer the ophthalmologist but also the patient a better possibility to detect changes or improvements before and after surgery. It is evident that surgery with new implants/devices is no longer the challenge, but rather the more complex management of patients before and after surgery as well as the correct selection of cases. 摘要: 年龄相关性黄斑变性(AMD)导致患者渐进性视力丧失, 严重影响其生活质量和日常活动能力。尽管有针对AMD的治疗性药物且临床用药还在研发中, 但针对晚期AMD患者的药物治疗相对匮乏。专门的康复计划及外部助盲设备能够改善进展期AMD患者的视力, 但是眼内植入式的设备包括可植入微型望远镜 (IMT) 和眼内晶体 (IOL), 在头部运动、前庭眼反射的发育及深度觉感知方面更具优势。IMT和IOL技术发展迅速, 并且还有很多可能从中获益的患者。本文通过回顾近期文献总结了进展期AMD患者植入视觉提高设备的可用的信息。此外, 本文讨论了近期研发用于改善生活质量的测试, 包括日常生活活动 (ADL) 和客观评估。这也为眼科医生和患者更好地监测手术前后视力改变或提高提供了可能性。显然, 使用新植入物或设备的手术不再是挑战, 而手术前后患者更复杂的管理以及病例的正确选择更具有挑战性。.
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