Accuracy Of A Look-Through Iol Simulator In Replicating The Optical Function Of Intraocular Lenses
Published 2025 - 43rd Congress of the ESCRS
Reference: FP29.02 | Type: Free paper | DOI: 10.82333/9h4n-gt90
Authors: Artem Zakharovich Ciganov* 1 , Svetlana Izmaylova 1 , Valeriia Suchkova 1 , Mariam Taevere 2
1Anterior Segment Transplant and Optical Reconstructive Surgery,S.Fyodorov Eye Microsurgery Federal State Institution,Moscow,Russian Federation, 2diagnostic department,S.Fyodorov Eye Microsurgery Federal State Institution,Moscow,Russian Federation
Purpose
Patient selection for presbyopia-correcting intraocular lenses is key to achieving high postoperative satisfaction. Although detailed preoperative counseling is often required, introducing a simulator that allows patients to experience their postoperative vision may simplify this process. The RALV (DEZIMAL GmbH) is a newly developed look-through IOL simulator that integrates a physical IOL into its optical system. To date, no studies have validated how accurately this device simulates the objective properties of IOLs, which this investigation aims to address.
Setting
David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Germany.
Methods
Basis Z Monofocal, extended-depth-of-focus (EDoF), and Trifocal IOLs, all from 1stQ GmbH, were evaluated. First, the optical quality of the IOLs was assessed using an optical metrology system that simulates natural eye conditions at 3-, 3.5-, and 4-mm apertures. Five phakic observers, under cycloplegia, performed visual acuity and defocus curve tests using the RALV, with IOLs mounted in the device via a lens shuttle. Landolt C optotypes were presented in random order on an integrated external screen.
Results
The defocus curves obtained with the RALV revealed an extended range of vision for the EDoF and trifocal IOLs. Visual acuity at 67 cm improved by approx. 0.2 logMAR with the EDoF and the trifocal compared to the monofocal control. At 40 cm, improvements were 0.3 logMAR (EDoF) and 0.6 logMAR (trifocal). Strong and statistically significant agreement (P<.001) was found between RALV-generated defocus curves and the objective quality metrics, with R² values near or above 0.9 for 3- and 3.5-mm apertures. At a 4-mm aperture, the agreement decreased, with R² ranging from 0.6 to 0.7.
Conclusions
We demonstrated that IOL simulations using the RALV device can differentiate between various IOL types. The strong agreement between the look-through simulator and optical-bench metrics indicates its accuracy in reproducing the optical properties of IOLs, particularly for photopic pupil sizes.