Impact Of The See-Through Visual Simulator Simvis Gekko On The Prediction Of Postoperative Visual Performance In Cataract Surgery With Multifocal Intraocular Lenses.
Published 2023 - 41st Congress of the ESCRS
Reference: FP12.02 | Type: Free paper | DOI: 10.82333/yard-wt14
Authors: Jorge Henriques* 1 , Tatiana Queirós 2 , Vera Afreixo 3 , Conceição Lobo 4 , Joaquim Murta 5
1Ophthalmology,CHUC,Coimbra,Portugal;Clinical Academic Center of Coimbra (CAAC),Coimbra,Portugal;Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal, 2Ophthalmology,CHUC,Coimbra,Portugal, 3University of Aveiro,Aveiro,Portugal, 4Ophthalmology,CHUC,Coimbra,Portugal;Clinical Academic Center of Coimbra (CAAC),Coimbra,Portugal;Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal;Associação para a Investigação Biomédica e Inovação em Luz e Imagem,Coimbra,Portugal, 5Ophthalmology,CHUC,Coimbra,Portugal;Ophthalmology,Clinical Academic Center of Coimbra (CAAC),Coimbra,Portugal;Ophthalmology,Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal
Purpose
SimVis Gekko (SVG) is a see-through visual simulator with an optotunable lens working in temporal multiplexing mode that uses visual Strehl ratio for the optical evaluation of the temporal profile.
The purpose of this study was to assess the real-life impact of the SVG on predicting postoperative visual performance in patients undergoing bilateral consecutive cataract surgery with multifocal or enhanced depth of focus (EDOF) intraocular lenses (IOL).
Setting
This study was held at Ophthalmology Department of Centro Hospitalar e Universitário de Coimbra, Portugal.
Methods
A prospective observational cohort study was designed.
We included patients aged between 50 and 69 years, with transparent lens or mild to moderate cataract, and best corrected visual acuity (VA) > 4/10, with indication and intention to underwent sequential bilateral cataract surgery with EDOF/trifocal IOL implantation.
A diffractive multifocal IOL [TFNT00/TFNT (20-60), Alcon Fort Worth, Tx, USA] or EDOF IOL [DFT015/DFTx15, Alcon Fort Worth, Tx, USA] were simulated for each patient preoperatively to improve their ability to choose between them. Distance, intermediate and near VA, the patient's subjective visual performance (on a scale of 0 to 10) and stereopsis were also measured pre and postoperatively.
Results
A total of 37 patients (n=37) were included. The mean age was 59.2 (+/- 9,2) years; 17 patients received the trifocal IOL and 20 the EDOF IOL.
The shape of the VA curve was statistically comparable between simulation and achieved postoperative VA.
The average preoperative subjective visual performance score with SVG was 7.9 (0-10) for the trifocal lens and 8 (0-10) for the EDOF lens, and all patients perceived the difference in visual performance between the two IOLs. The postoperative subjective visual performance was 9.2 (0-10) for the trifocal lens and 8.8 (0-10) for the EDOF lens. Thirty-three patients (89.2%) described the simulation as very useful for deciding between the two IOLs.
Conclusions
SVG showed a good ability to simulate EDOF and trifocal IOLs at the preoperative evaluation in terms of VA for distance, intermediate, and near, including the shape of the curve.
This instrument appears to be useful for the patient's decision-making process, as most patients described the simulation as very useful for deciding between the two IOLs (whenever clinically applicable). Overall, the patients' subjective postoperative performance, VA, and stereopsis exceeded the preoperative simulation, which is attributable and consistent with cataract extraction.