It has now been eight months since the first Scharioth Macular Lens (SML) was implanted in Australia and according to the patient, Anne Benz, the innovative technology has been life changing.
Ms Benz (86 years), who was recommended for the implant by her Sydney ophthalmologist Dr Brian Harrisberg, is visually disabled due to wet and dry macular degeneration in her right eye and end stage macular scarring in her left eye. She said prior to the implant she had not been able to read a book for three years. Supermarket shopping, and incidental reading for everyday life, had become impossible.
“To read the ingredients on a package in the supermarket I would need to look through a magnifying glass while wearing glasses and even then, I would have to ask for help. Now, although I have to hold the item 14cm from my eye, I am able to read labels independently.”
Ms Benz says the implant has also enabled her to manage administrative paperwork and enjoy finding out about what is going on in the community.
To demonstrate her new found visual freedom, Ms Benz read aloud the program of events coming up at her local gallery. Then, she began to laugh. “It’s quite strange but I just keep laughing – I can’t believe how much this has changed my life,” she said.
Ms Benz said she was excited to be the first patient in Australia to receive the implant.
“Dr Harrisberg had been looking for a device to help me for some time so when he told me about the Scharioth, I could hardly wait. I had complete faith in his recommendation and ability to implant the device successfully.” Dr Harrisberg, who has now implanted three SMLs and has two patients awaiting the procedure, said Ms Benz was the ideal candidate for the lens, which is designed to meet the needs of a select cohort of patients.
“Anne is informed, she is highly aware of her visual world, and has specific demands for her vision. A sketch artist who appreciates detail, she was losing the ability to pursue this hobby and I didn’t want that to happen,” he said.
“Her macular degeneration was relatively stable, and anatomically she met the criteria for an SML – she had space in the ciliary sulcus for an add on lens, she had a healthy cornea and no history of angle closure glaucoma – which is a relative contraindication.”
Ms Benz said getting used to the lens was relatively easy.
“I was instructed to read for 20 minutes, twice a day. This was tiring, and unenjoyable because the lens forces you to read word by word as opposed to scanning phrases or even complete sentences.”
Having committed to reading an entire book with the new lens, Ms Benz said this is not something she would do again. “I completed the book but it was slow and not pleasurable and for me, reading has always been a relaxing and pleasurable experience. I’d rather lie down on the couch, close my eyes and let an audible book take me on a journey,” she said.
According to Dr Harrisberg, this response is to be expected.
“As we know with any magnifying device, you have a very limited field of view, so your reading is incredibly slow. I wasn’t expecting Anne to be a good reader but she can read if she’s prepared to put in the time for slow scanning across the page. Importantly, this is a device that is with her all the time – there is no need to carry a magnifier around with her. So both her hands are free to use when reading the mail, sketching and going about daily life such as shopping and reading labels.”
Ms Benz said learning to get the most from the SML is an ongoing experience.
“Originally it took time for me to stop reaching for my glasses and I had to remind myself that my glasses no longer helped me, I needed to use my new eye. Even after eight months, on a daily basis I am still finding new ways to read using the SML.”
She continues to wear sunglasses with a prescription for distance and is exploring the possibility of glasses to assist with intermediate distance for computer use and household chores.
“Sunglasses and a hat are essential when I go out outdoors, as they are for all people with macular degeneration,” she said.
Dr Harrisberg said he was pleased with the results from the first SML implant.
“My initial reaction to Anne’s procedure was very favourable because we matched her expectations.”
Despite his success with Ms Benz and two other patients to date, he observed that the SML is not a solution for everyone.
“For anatomical reasons (described previously) it is suitable for a highly selective cohort. It needs a lot of chair time – it takes time to demonstrate the device to patients, to answer their questions, and to ensure they feel comfortable with it.”
He said if a patient is unhappy with the result, the SML is easily removed from the sulcus. This differs from removing lenses from inside a capsular bag which is technically more difficult.
The SML is distributed in Australia by Insight Surgical.