Maculopathy affects the macula, the area of the retina responsible for central and detailed vision: reading, recognizing a face, driving. It is a progressive and, in most cases, irreversible condition. EyeMax Mono is an intraocular lens (IOL) designed specifically for patients with maculopathy: it is not a cure, but it is intended to optimize the use of the still-healthy areas of the retina, improving the quality of the perceived image and, for many patients, the ability to read, recognize faces, and move with greater independence. It is also available in Italy.
What is EyeMax Mono
EyeMax Mono belongs to the family of intraocular lenses (IOLs): devices that, through microsurgery, replace the natural lens — typically during cataract surgery. Unlike standard monofocal IOLs, however, EyeMax Mono is designed specifically for those living with maculopathy, to make the best use of the still-healthy areas of the retina when central vision is compromised.
It is made of UV-absorbing, hydrophobic, and flexible yellow acrylic — a biocompatible material widely used in ophthalmic surgery — with a single-piece injectable square-edge design that takes chromatic and spherical aberration into account. It originated as an evolution of previous projects for visual rehabilitation in maculopathy, such as the intraocular telescope known as iolAMD or the “Hubble Implant”, and was developed by Dr. Bobby Qureshi (London Eye Hospital) together with Prof. Pablo Artal (University of Murcia). It is manufactured by SharpView Ophthalmology Limited and has obtained the CE mark (number 2460), which certifies its compliance with the safety and performance requirements for medical devices in the European Union.
How it works: transverse asphericity
In people with maculopathy, the central part of the macula (the fovea), normally responsible for the sharpest vision, is damaged. The eye and brain then try to compensate by shifting fixation to a still-healthy area of the macula, further out from the center: a new reference point known as the preferred retinal locus (PRL). The problem is that, as you move away from the fovea, photoreceptor density decreases — therefore, vision obtained through the PRL is naturally less sharp.
This is where the design of EyeMax Mono comes in. The lens uses an optical principle called transverse asphericity: instead of concentrating focus on a central point like standard IOLs, it extends and optimizes image quality over a wider area of the macula, helping the brain better utilize the PRL. In practice, it works much like a wide-angle lens: it slightly magnifies the image (by about 1.1–1.2 times) and projects it not only to the center, but also onto the still-functioning peripheral zones of the macula.
Most IOLs on the market are designed for a narrow focal area, usually within 5° of the foveal center — a radius that often already falls within the zone damaged by the disease. EyeMax Mono extends this area up to 10° from the foveal center across the entire macula: double the radius, and thus a retinal focal area 4 times larger than a standard IOL.
Who it is indicated for
The assessment is always individual and must be done with your ophthalmologist: not all patients with macular problems are ideal candidates. Generally, EyeMax Mono is considered for three groups of patients:
- AMD with cataract: dry age-related macular degeneration or stabilized wet form, scheduled cataract surgery, healthy macular area within 10° of the fovea.
- AMD with non-visually significant cataract: the cataract itself is not the factor limiting vision.
- Other retinal pathologies with stable fixation: macular hole, Stargardt disease, macular scar, central serous chorioretinopathy (CSCR), epiretinal membrane, and acquired vitelliform lesions (AVL) — subretinal deposits that can appear in various macular diseases.
The common prerequisite for all indications is the presence of a peripheral portion of the macula that is still functionally viable: exams such as OCT and microperimetry help the ophthalmologist map it and estimate the potential benefit before the surgery.
Clinical results and safety
Published evidence on EyeMax Mono currently covers nearly 700 eyes, including clinical trials and case series. Overall, published data show an average improvement in visual acuity of up to 18 ETDRS letters, with an average postoperative follow-up of about 7 months. In the largest series — 244 patients with AMD, published by Qureshi and colleagues in 2018 — the mean improvement was 3.5 lines for distance vision and 4.8 lines for near vision.
The benefits do not seem limited to cases where cataracts play a major role: a long-term study (follow-up up to 9 years, averaging over 4) on 113 eyes with non-visually significant cataracts showed an improvement in distance vision of at least one line in 95% of cases. A finding that, according to the authors, indicates a direct contribution from the lens’s optical design, distinct from the effect of cataract surgery alone.
In terms of safety, the profile of EyeMax Mono is comparable to that of standard monofocal IOLs, with no reports in the literature of safety issues or explantations related to the lens. It is important to have realistic expectations: EyeMax Mono does not stop the progression of maculopathy, and the visual benefit depends on the portion of the peripheral macula that is still healthy. Results vary from patient to patient.
The procedure, in brief
The implantation is performed using a well-established microsurgical technique, almost always in the same session as cataract surgery (or, for those who have already had cataract surgery in the past, as a standalone secondary procedure). The operation generally lasts 10-15 minutes per eye, is performed under local anesthesia in a day-surgery setting, with no overnight hospital stay required. A detailed account of what to expect before, during, and after the surgery can be found in the article Living with maculopathy and the promise of EyeMax Mono.
Sources
- Qureshi M.A. et al., “Consecutive case series of 244 age-related macular degeneration patients undergoing implantation with an extended macular vision IOL”, European Journal of Ophthalmology, 2018.
- Badalà F. et al., “Long Term Visual Outcomes of an Extended Macular Vision IOL in Eyes with Macular Disease and Visually Insignificant Cataract”, Clinical Ophthalmology, 2024.
- Hengerer F.H. et al., BMC Ophthalmology, 2025.
- SharpView Ophthalmology, Data Summary EyeMax Mono, March 2025 (dossier SHV/EMM/001/a).
The information presented in this article is for purely informational and educational purposes and does not in any way replace the advice of an ophthalmologist. For any doubts or needs regarding your eye health, it is essential to consult a specialist.
