Intraocular Telescope Shines Light on AMD-Damaged Eyes

Neil Osterweil

April 07, 2014

TOKYO — A microscopic telescope implanted in the eye can improve vision in people with atrophic or "dry" age-related macular degeneration.

The telescope is designed to help patients with precious few treatment options, said its inventor, Isaac Lipshitz, MD, from the Lipshitz Vision Center in Herzlia, Israel.

"The advantage of intraocular telescopes, compared with other low-vision devices, is that there is no relative movement between the eye and the telescope," he said.

Dr. Lipshitz presented the results of 3 implantations of the intraocular telescope here at the World Ophthalmology Congress 2014.

The device, dubbed the OriLens (OptoLight Vision Technology), is a miniature Cassegrain-type reflecting telescope, a variation of a design by Sir Isaac Newton. The telescope gathers light on a primary mirror and bounces it to a smaller secondary mirror, which in turn distributes the light to areas of the retina unaffected by macular degeneration.

In 2010, the US Food and Drug Administration (FDA) approved a previous intraocular telescope designed by Dr. Lipshitz, as reported by Medscape Medical News. That device, the first of its kind to get the FDA nod, incorporates miniature lenses to create a refractive, minuscule version of a Galileo-type telescope.

The OriLens, which can be used in patients with phakic or pseudophakic lenses, makes it easier for patients to read without having to move their heads for scanning, and provides a wider visual field than external telescopes or magnifiers, Dr. Lipshitz explained.

Anat Loewenstein, MD, chair of ophthalmology in the Sackler Faculty of Medicine at Tel Aviv University in Israel, told Medscape Medical News that her team has had experience implanting the device in 1 eye.

"It's an intriguing device, and the implantation that we did was pretty straightforward. The patient had improved visual acuity after the procedure. Later on she developed some intraocular pressure, which I'm not sure was related to this device in any way," said Dr. Loewenstein, who was not involved in the development of the device.

Secondary Intraocular Lens

The telescope is shaped like a standard round intraocular lens, with a 5 to 6 mm optic diameter and loop haptics that are fixated in the ciliary sulcus. The device is implanted over a standard intraocular lens implanted within the capsular bag.

According to Dr. Lipshitz, the devices can be safely implanted by any cataract surgeon.

The OriLens preserves at least part of the patient's remaining peripheral vision, and has not been shown to damage the corneal endothelium. It can also be used as a low-vision aid in people with other diseases of the retina, he noted.

In all 3 early cases of implantation presented by Dr. Lipshitz, visual acuity on the ETDRS scale improved. There were no major intraoperative or postoperative complications.

"I attended the procedure, which was done by a cataract surgeon, and it went very smoothly," Dr. Loewenstein told Medscape Medical News about the experience at her center.

She noted that the device could be limited to patients with phakic or pseudophakic lenses, and might not help patients lacking a natural or artificial lens.

Dr. Lipshitz acknowledged that the device is costly, at more than €5000 (about $6850).

Dr. Lipshitz is the inventor of the OriLens and chair and CEO of OptoLight Vision Technologies. Dr. Loewenstein has disclosed no relevant financial relationships.

World Ophthalmology Congress (WOC) 2014: Abstract FP-FR-18. Presented April 4, 2014.

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