Preoperative Evaluation Of Glare With Multifocal Intraocular Lenses Using A Binocular Visual Simulator
Published 2024 - 42nd Congress of the ESCRS
Reference: PO558 | Type: Free paper | DOI: 10.82333/fks2-js39
Authors: Petros Papadogiannis* 1 , Victor Rodriguez - Lopez 2 , Albetro de Castro 2 , Lucie Sawides 2 , Enrique Gambra 1 , Alejandra Varea 3 , Susana Marcos 4 , Scott MacRae 5 , Irene Sisó-Fuertes 1 , Carlos Dorronsoro 3
12EyesVision SL,Madrid,Spain, 2Institute of Optics, Spanish National Research Council (IO-CSIC),Madrid,Spain, 32EyesVision SL,Madrid,Spain;Institute of Optics, Spanish National Research Council (IO-CSIC),Madrid,Spain, 4Institute of Optics, Spanish National Research Council (IO-CSIC),Madrid,Spain;Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester,New York,United States, 5Department of Ophthalmology, Department of Visual Science, University of Rochester, Rochester, New York,New York,United States
Purpose
The purpose of the study was to measure and quantify glare (halo, starburst, streaks) of trifocal, Extended Depth of Focus (EDOF) and bifocal Intraocular Lenses (IOLs) simulated by a commercial binocular visual simulator (SimVis Gekko, 2EyesVision). The aim was to measure and compare the glare size from psychophysical measurements with estimations from computer simulations, and to evaluate the visual symptoms using a shortened version of the AIOLIS questionnaire.
Setting
Visual Optics and Biophotonics Lab, Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
Methods
Ten healthy subjects (27-51 yo) participated. A visual simulator (SimVis) was used to simulate 10 IOLs: 3 trifocals (Synergy,PanOptix,FineVision), 3 EDOF (Vivity,Symfony,Isopure), 3 generic bifocals (1.5,3&4.5D near add) and a monofocal. The Halo Software (Univ Granada) with a central LED was used to measure the perceived glare size; computer simulations to predict the glare size of the monofocal & bifocals for eyes with and without wavefront aberrations; and a questionnaire (AIOLIS) to assess the visual symptoms. The average glare size in arcmins (´) was calculated for each IOL, the Friedman test was done to compare the glare sizes & the Spearman test to assess the correlation between halo sizes and responses from the AIOLIS questionnaire.
Results
Average glare size was 7.2´(SD=0.54) and 4.4´ (SD=0.83) for trifocals & EDOFs, respectively. Higher addition yielded larger glare size (5.2´ to 11´) in the bifocals. The 4.5D-bifocal produced the biggest glare (11´) & the monofocal the smallest (2.9´). There were statistically significant differences (Q=75.33,p<0.05) in glare size across IOLs, but no differences within the trifocals (Q=2.6, p>0.05) or within the EDOFs (Q=8.6, p>0.05). The questionnaire results were highly correlated with the glare size results (rs >0.97) showing that larger glares disturbed the subjects more. The computational results predicted the experimental results (R2=0.99, mean difference ~1´) and indicated a minor effect of wavefront aberrations in normal subjects.
Conclusions
SimVis Gekko proved to be a sensitive tool to demonstrate differences in photic phenomena across different multifocal IOLs prior to surgery. The size of the glare perceived through the visual simulator with each of the presbyopic corrections was directly correlated with the reported symptoms, and with the simulations. Results showed that trifocals produced larger glare than EDOFs, the 4.5 D bifocal yielded the biggest glare and the monofocal the smallest. Computational simulations suggest a minor impact of wavefront aberrations in normal subjects on the size of glare. AIOLIS questionnaire responses aligned linearly with glare size, indicating that larger glare was associated with greater disturbance.