Purpose: To report the outcomes of macular add-on intraocular lens implantation in improving reading vision in patients with bilateral advanced diabetic maculopathy.
Methods: In this retrospective study, a supplementary bifocal sulcus intraocular lens (Scharioth Macular Lens) was implanted in the better-seeing eye of five patients. Baseline-corrected distance vision, corrected near visual acuity, a preoperative simulation test, and multimodal imaging were collected. The primary outcome was the uncorrected near visual acuity at a working distance of 15 cm, at a 12-month follow-up.
Results: Study patients included 3 cases of refractory subfoveal exudation and 2 cases of diabetic macular ischemia. A preoperative test to assess the potential gain in near vision showed an improvement of ≥2 paragraphs on the RADNER reading chart in all patients. At 12 months, median reading vision (corrected near visual acuity at 15 cm) significantly improved from 20/125 (range 20/50-20/200) preoperatively to uncorrected near visual acuity (at 15 cm) of 20/50 (range 20/40-20/80) (P = 0.042; Wilcoxon signed-ranks test). Distance vision remained unchanged in four patients. All patients were able to achieve the size of newsprint (20/50 Snellen equivalent), within the first 3 months.
Conclusion: The macular add-on intraocular lens improves reading vision in visually impaired patients due to end-stage diabetic macular disease.