The implantable miniature telescope (<scp>IMT</scp>) new developments: The <scp>US</scp> and <scp>UK</scp> experience

The Implantable Miniature Telescope (IMT) is a viable option for patients afflicted with decreased vision in both eyes (20/160 to 20/800) from the advanced form of dry age‐related macular degeneration. It has a 21‐year history of being both safe and effective. The IMT uses a Galilean telescope design that utilizes wide‐angle quartz micro‐optics when used in conjunction with the cornea to create a telephoto system that magnifies objects in view by 2.7X. This axial magnification allows central images to be projected onto healthy paramacular areas of the retina instead of the fovea alone, thereby reducing the central blind spot and allowing the patient to discern images that may have been previously unrecognizable or difficult to see. The IMT is both FDA approved and carries a CE mark. The FDA lowered the minimum age from 75 to 65 years of age, based on the 5‐year FDA data that showed slightly more visual improvement in younger patients than patients aged 75 years and older. Based on the UK experience, the FDA initiated an independent study on pseudophakic patients to monocularly exchange a posterior chamber intraocular lens for the 2.7X IMT, but unfortunately recruitment was inadequate to derive useful data. An injectable form of the IMT (SING) is currently being investigated in the US and UK which shortens the surgical time, incision length and capsulorhexis requirements. As the incidence of advanced age‐related macular degeneration increases due to the development of geographic atrophy, the IMT should be strongly considered in patients who are visually symptomatic in order to gain an increase of daily living.