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Visual quality with preoperative multifocal corrections simulated with SimVis Gekko in cataract patients

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First Author: X.Barcala SPAIN

Co Author(s):    A. Zaytouny   R. Sanchez-Jean   D. Rego-Lorca   J. Sanchez-Quiros   S. Marcos   C. Dorronsoro     

Abstract Details

Purpose:

SimVis Gekko (2Eyes Vision, Madrid) is a binocular visual simulator that allows us to experience vision with different presbyopic corrections before surgery. Multifocal Acceptance Score to Evaluate Vision (MAS-2EV) is a multidimensional visual quality metric. Combining SimVis Gekko and MAS-2EV, we have estimated preoperatively visual perception with different presbyopic corrections in patients with different degrees of cataract and studied the suitability of these technologies in the presence of a cataract.

Setting:

Visual Optics and Biophotonics Laboratory (Viobio Lab), Instituto de Optica, Spanish National Research Council (IO-CSIC), Madrid, Spain Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain.

Methods:

Twenty-five patients (age: 71±10 yo Rx:-0.56D±1.82D, cyl≤-0.96D±0.68D) scheduled for bilateral cataract surgery participated in the study. The degree of cataract was evaluated with OQAS OSI-index (Visiometrics). Patients judged the perceptual quality of images at near and far (Perceptual Scores: 0-10; MAS-2EV metric) through the SimVis Gekko simulating the IOL designs: Monofocal far (both eyes; FF); Monovision (far dominant eye/near contralateral eye; FN); Modified monovision (far dominant eye/bifocal contralateral eye; FB); Bifocal (both eyes; BB). Three repetitions were performed for each correction at each distance.

Results:

FF correction was the best correction @far (PS=8.6±1.1) and decreased @near (PS=4.6±2.4). All presbyopic corrections produced a visual benefit @near (by 23.3±27.6% compared to monofocal FF, on average across corrections/subjects) except for patients with OSI>5. Interestingly, the visual degradation @far was constant for each presbyopic correction, regardless cataract level (for OSI<5=-36.4±27.2%; for OSI>5=-36.1±25.6%; FN p=0.8; FB p=0.3; BB p=1). PS decreased with increasing OSI for most corrections @far (FF p=0.006 R=-0.5; FN p=0.01 R=-0.5; FB p=0.006 R=-0.5), however PS for FF @near increased with OSI (FF p=0.0016, R=0.6).

Conclusions:

The study demonstrates that SimVis Gekko is applicable to patients with cataracts, allowing to show the benefit of a near correction in a large cataract scattering range (OSI<5). The relatively large acceptance of blur at far (with presbyopic corrections) and particularly at near (with monofocal far correction) may be suggestive of neural adaptation to natural blur, especially in patients with denser cataract.

Financial Disclosure:

... has significant investment interest in a company producing, developing or supplying product or procedure presented, ... is employed by a for-profit company with an interest in the subject of the presentation