EURETINA 2026: Cataract surgery with the EyeMax Mono IOL and structured rehabilitation in late-stage AMD

At the 26th EURETINA Congress in Vienna, Austria, Paola Sasso, MD, and Antonio Baldascino, MD, presented a study of functional outcomes in patients with cataract and late-stage age-related macular degeneration (AMD). The patients were implanted with the EyeMax Mono IOL and then completed visual rehabilitation. Sasso outlined the study design and results. Baldascino, of the Catholic University in Rome and the study’s surgeon, described the lens and surgical approach.

A 3-step approach

Sasso described a small group of patients with cataract and stable macular degeneration. The study was built on 3 steps: patient selection, surgery and rehabilitation.

Patient selection was based on clinical characteristics and on instrumental evaluation. OCT was used to assess anatomical damage to the macula. Microperimetry measured functional parameters, including retinal sensitivity, fixation stability, reading speed and preferred retinal locus (PRL) location. “These parameters are very important for this critical step of selecting patients,” Sasso said.

After surgery, patients completed a structured rehabilitation programme. It included fixation stability training, oculomotor coordination and saccadic movement exercises, and exercises to reinforce reading ability and reading-related tasks.

Functional gains without change in retinal sensitivity

According to Sasso, patients improved in visual acuity and also in fixation stability, the PRL and reading performance. Retinal sensitivity did not improve. Sasso said this shows that the functional improvement, and patients’ ability to carry out many daily activities, is related to the PRL.

Lens design and surgical technique

Baldascino described the EyeMax Mono as an extended macular vision IOL designed to optimise image quality across the central part of the retina. The single-piece hydrophobic lens can be implanted during routine cataract surgery, even through a 2.5-mm corneal incision, and is placed in the capsular bag at the end of the procedure.

Refractive target and patient counselling

Based on the study, Baldascino said the team considers 1.5 dioptres of hyperopia the best refractive target for this surgery. In their experience, this target gives better results with near-vision spectacles. He stressed telling patients before surgery that they will need spectacles for both distance and near vision afterwards.

“It is also very important to perform a routine cataract surgery without any complications when using this procedure,” Baldascino said.