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Telescope for Macular Degeneration?

FDA Eyes Implantable Miniature Telescope When All Else Fails to Treat Macular Degeneration

How the Implantable Telescope Works

The telescope magnifies images by recruiting other parts of the retina to make up for the loss of the macula. "What it does is it enlarges the image that the patients can see to compensate for their macular degeneration, Colby says.

In the telescope's clinical trial, 206 patients took eye tests before getting the implantable miniature telescope. One year later, 67% of them could read at least three extra lines on the doctors' eye chart, compared to their eye test results before getting the telescope.

"One of the patients I implanted actually was able to return to a long-loved avocation of sculpting that he had had to give up," Colby says.

Surgical Risks

Implanting the telescope is "challenging surgery," says Colby, who wrote a paper about the procedure in the August 2007 edition of the Archives of Ophthalmology.

Four millimeters may sound small, but for the eye, "it's a large device, so it needs to be placed in the eye carefully to avoid damaging other structures within the eye," Colby says.

Those structures include the cornea, which is the eye's outermost layer.

In the telescope's clinical trial, patients had lost 25% of certain corneal cells one year after surgery. That didn't meet the study's benchmark of losing no more than 17% of those cells. Cornea specialists met that goal, but not all of the surgeons who took part in the study were cornea specialists, Colby notes.

The trial's results, published in Ophthalmology in November 2006, show that most of the corneal cell loss occurred from postsurgery swelling, not because of ongoing trauma caused by the telescope.

Lloyd notes that after getting the telescope, several patients in the clinical trial later needed a corneal transplant. That may be in part because of their advanced age (participants were 76 years old, on average), Lloyd says.

Tips for Patients

If the FDA approves the implantable miniature telescope, Lloyd and Colby have some advice for patients.

First, keep your expectations reasonable. For instance, "it's not realistic to hope that you're going to be able to drive," Colby says.

Second, choose your surgeon carefully. Lloyd suggests asking these questions:

  • What are the risks, the benefits, and the alternatives?
  • Where did you learn how to do this procedure?
  • How many of these operations have you done?
  • What is your success rate with this operation?

"It's early going. These things are going to require a lot of care and a lot of follow-up, and a steep learning curve," Lloyd says.

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