Effect of cataract on preoperative predictions of multifocal acceptance with SimVis Gekko

Session Details

Session Title: Multifocal IOLs II

Session Date/Time: Monday 16/09/2019 | 08:30-10:30

Paper Time: 09:38

Venue: Free Paper Forum: Podium 1

First Author: : X.Barcala SPAIN

Co Author(s): :    M. Romero   N. Garzon   F. Poyales   E. Gambra   S. Marcos   C. Dorronsoro              

Abstract Details

Purpose:

Visual simulators allow patients to experience vision with a given correction prior to surgery. We evaluated the influence of various degrees of cataract in patients using a binocular simultaneous vision simulator (SimVis Gekko; 2EyesVision, Madrid) to judge the perceived quality of images. The scored images were part of a multi-image environment (Multifocal Acceptance Score to Evaluate Vision; MAS-2EV).

Setting:

IOA Madrid Innova Ocular, Madrid, Spain

Methods:

Eleven patients (Rx:-6.50 to +4.00D, cyl<-1.50D) with bilateral cataracts were measured pre-operatively with SimVisGekko. A control group (10 subjects) was also measured. The degree of cataract was evaluated with a slit-lamp (Barraquer scale) and the OQAS OSI-index (Visiometrics). Five binocular IOL designs were simulated: Monofocal far (both eyes); Monovision far(dominant eye)/near(contralateral eye); Modified monovision far(dominant eye)/bifocal(contralateral eye); Bifocal (both eyes); Trifocal (both eyes). Near add was +2.50D. MAS-2EV comprises stereoacuity and perceptual scores (PS, 0-10). Patients and controls scored the images presented on a HDR monitor and an iPad for the 5 corrections at 3 distances, with 3 repetitions.

Results:

A large range of cataract levels was evaluated (OSI 1.1 to 9.6, mean 4.85, Barraquer N3 to N5C3PSC) in which patients presented a high bilateral similarity (avg difference OSI 1.15; 0.22 Barraquer steps). Patients scored image quality consistently, with average deviation across repetitions between 0.21 (Patient#1) and 0.86 (P#5) PS, 0.42 on average. The difference in PS between best-worst corrections was 9.6 in P#8 and 0.67 in P#3, 4.39 PS, on average across patients and distances, mean 4.36 PS in the control group. PS across subjects, corrections and distances are not correlated with opacification (p=0.4299).

Conclusions:

SimVis Gekko was capable of presenting presbyopic correction experiences (different multifocal corrections, monovision and modified monovision) in cataract patients, who, independently of the presence of the cataract could judge and rank the perceived visual quality with the corrections in a realistic image environment. Visual simulators in combination with MAS-2EV metric can be used pre-operatively in the clinic, to aid the prescription of presbyopic corrections.

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