What is the Scharioth Macula Lens?
The Scharioth Macula Lens (SML) is a magnifying add-on lens implant, designed for eyes which have already had cataract surgery and which also have macular disease such as macular degeneration. It aims to improve reading vision and near visual function significantly, by enabling reading of small print at short distances of around 15cm.

The SML implant has 4 feet which keep it centered in the ciliary sulcus, in front of the eye’s natural lens capsule, but behind the iris.

Where was the SML developed?
The inventor of this lens, Professor GB Scharioth, is an ophthalmic surgeon in Germany. The SML implants are manufactured by Medicontur, who manufacture a range of intraocular lens implants and other ophthalmic surgical accessories.

What research has been undertaken on the SML so far?
In his first published series from 2015, 7 out of 8 patients experienced improvement in reading vision after surgery, with no effect on their distance vision. Furthermore, the lens was found to be safe with no intra-operative or post-operative complications. Larger studies are already underway, aiming to collect more data from a higher number of patients.

How is the SML different from other “telescopic” lens implants advertised for age-related macular degeneration?
Telescopic lens implants for patients with macular disease were first trialled some 20 years ago and have never really caught on, due to astronomical costs owing to their complex optical design, loss of peripheral vision, and (for the older designs) large incision sizes and difficulty of reversal. Even the modern telescopic lens implants (i.e. those which aim to improve distance vision) still cause limitation of peripheral vision – a necessary side-effect by the simple laws of optics. For this reason, many patients have expressed deep regret and unhappiness with these telescopic implants.

By contrast, the SML is designed to magnify for near, rather than distance, and by its design has no effect on the peripheral vision which patients with macular degeneration are so reliant upon. The trade-off is that in order to benefit from the magnification for reading, the material being read needs to be just over twice as close to the eye than normal reading distance (i.e. 15cm vs 30-40cm). However many elderly patients with macular degeneration will still find this significantly easier than holding a magnifying lens steady at a similar distance.

Is the SML suitable for implantation in both eyes?
No, the SML is designed to be implanted in the better eye only.

What happens if patients are not happy with their vision after SML implantation?
The SML implant is relatively easy to remove, because it sits in front of the lens capsule rather than within it. This means that if patients are not happy with the results, a second operation (to remove the SML implant) should effectively reverse the operation.

Would I be suitable for the SML implant?
The criteria list for SML suitability – and the list of suggested clinical exclusions – are relatively long and the SML will only be suitable for some patients with macular disease. The SML implant should only be considered after a thorough evaluation of your macular disease, visual function, and other ocular parameters.

How many SML implants have been done in Jersey?
Mr Shah performed the first SML procedure in Jersey in May 2017; initial results are very promising but longer follow-up is required before drawing conclusions in this case.