Safety and efficacy of an intraocular Fresnel prism intraocular lens in patients with advanced macular disease: Initial clinical experience

PURPOSE: To perform a pilot study of a new in-the-bag Fresnol prism intraocular lens (IOL) designed to deviate the image from diseased to healthy retina in eyes with bilateral age-related macular degeneration (AMD). SETTING: Anterior segment subspeciality practice, Pretoria, South Africa. DESIGN: Prospective nonmasked trial. METHOD: Cataract surgery and unilateral implantation of the prismatic IOL were performed in patients with bilateral AMD and cataract. Outcomes were surgical complications, subjective and objective visual improvement, and undesirable optical effects. RESULTS: Three eyes of 3 patients were evaluated. All patients reported displacement of the scotoma, and no patient reported diplopia. The only complication was posterior capsule opacification (1 eye). CONCLUSIONS: Patients noted improved vision and no diplopia. This pilot was performed using a prototype IOL with single power and single angle of deviation; however, there is scope for individual patient optimization. This new technology merits further research and development because it may benefit large numbers of patients with stable end-stage AMD.