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Telescope Implant Restores Central Sight in Certain Patients with AMD

Device is now FDA-approved for younger patients—those aged 65 and older.

BY KAREN APPOLD, CONTRIBUTING WRITER

The Implantable Miniature Telescope (IMT) device, developed by VisionCare Ophthalmic Technologies (Saratoga, CA), has enabled certain patients with advanced AMD to perform tasks they no longer could, such as recognize faces and read large print, after losing central vision.

Before October 2014, the FDA had only approved the implant for patients ≥75 years old. It is now approved for patients 65 and older. “We have long-term data demonstrating that younger patients do well with the IMT both from a surgical perspective and in maintaining their improved vision over a long period of time,” says Allen W. Hill, president and CEO of VisionCare.

David Boyer, MD, of Retina-Vitreous Associates Medical Group, Beverly Hills, CA, has used the IMT to improve quality of life for patients with stable AMD and cataracts who have exhausted other options. “Some patients have given great feedback,” he says.

According to Hill, the IMT is the only FDA-approved surgical or implantable device to treat AMD. It incorporates wide-angle micro-optical lenses in a Galilean telescope design that works with the cornea to enlarge images to 2.7 times their normal size.

“The magnification allows central images to be projected onto healthy perimacular areas of the retina instead of the macula alone, where a breakdown of photoreceptors and loss of vision has occurred,” Hill explains. “Images are enlarged to reduce the impact of the central blind spot, which allows patients to distinguish and discern images that may have been unrecognizable.”

PATIENT ELIGIBILITY

Patients diagnosed with bilateral end-stage AMD, wet or dry, are potential candidates for the IMT. Importantly, candidates must not have had cataract surgery in the eye in which the IMT will be implanted or treated for active wet AMD in the previous six months.

The IMT, along with the CentraSight treatment program, was developed to help patients to follow the necessary steps for proper diagnosis, surgical evaluation, and postoperative care.

ONGOING TRAINING

Potential candidates for the IMT undergo rigorous screening to see whether they will visually tolerate the implant. “Neovascular patients must have a retinal exam showing they’ve been stable for the past six months before considering implantation,” Dr. Boyer says.

Following an outpatient surgical procedure, in which the IMT is placed in the capsular bag, patients must visit a low-vision occupational therapist to learn how to use their new vision. “Patients retrain their brain to understand what they see when only one eye will be used to see ahead and the other is used to see peripherally,” Hill explains.

BENEFITS FOR EVERYONE

Individuals with severe to profound vision impairment due to end-stage AMD implanted with VisionCare’s 2.7× telescope experienced a mean four-line gain in VA.

This year, CMS has significantly increased reimbursement levels and modified payment guidelines for the implant. “Now, the outpatient surgical procedure for telescope implantation will be reimbursed in ambulatory surgical centers at levels comparable to the newly increased levels provided in hospital outpatient settings,” Hill reports. “Ophthalmic surgeons can now perform the telescope implantation in the same location where they already perform most of their surgeries. This will significantly improve patient access and bolster ophthalmologist and healthcare provider efficiency. Ultimately, the procedure is now more economically viable for the surgeon to perform and recommend to patients.” RP