Effect Of Minimizing Light Exposure Intensity Of 3D Digital Visualization (Ngenuity®) On Macular Function After Cataract Surgery In Patients With Early And Intermediate Amd : A Comparative Erg Study

Published 2025 - 43rd Congress of the ESCRS

Reference: PO313 | Type: Free paper | DOI: 10.82333/f916-hg47

Authors: Wakako Imamura* ¹ , Takahiko Hayashi ¹ , Yusuke Hara ¹ , Chihiro Sunouchi ¹ , Kentaro Yuda ² , Takashi Kojima ³ , Naoko Kato ⁴ , David Gunn ⁵ , Brendan Cronin ⁵ , Shizuka Koh ⁶ , Akira Matsuda ¹ , Satoru Yamagami ¹

¹Department of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine,Tokyo,Japan, ²Kikuna Yuda Eye Clinic,Yokohama,Japan, ³Nagoya Eye Clinic,Nagoya,Japan, ⁴Minamiaoyama Eye Clinic,Tokyo,Japan, ⁵The Queensland Eye Institute,Brisbane,Australia, ⁶Osaka University,Osaka,Japan

Purpose

To assess the change from baseline of retinal response amplitude in voltage (μV) in patients with early and intermediate Amd, one hour after cataract surgery performed with NGenuity compared to standard light condition with SOM.

Setting

This study was conducted at Guillaume de Varye Hospital (Bourges), France, between June 2023 and April 2024, where a population of 42 patients undergoing cataract surgery with signs of early AMD, including medium-sized drusen (between 63µm and 125µm in diameter), or patients with intermediate-stage AMD with large drusen (>125µm) or retinal pigmentation abnormalities associated with at least medium-sized drusen. The surgeries were performed by the same surgeon (OS).

Methods

A randomized prospective study where one group of patients was operated under low light conditions (5%) NGenuity group, and the other under standard light conditions of the microscope at 60% (SOM).
Several criteria were analyzed, including electroretinography, visual acuity, and macular OCT. The exams were performed preoperatively (V1), one hour after he surgery (V2), the day after surgery (V3), and one month after surgery (V4). The primary outcome was the Photopic ERG b wave amplitude change from V1 to V2. Secondary outcomes included visual acuity, Photopic ERG b wave amplitude, the latency time of b-wave, visual acuity, and macular thickness at V2, V3, and V4.

Results

20 patients were operated under 5% light exposure (Ngenuity® group) and 21 under standard visualization (SOM). One patient withdrew their consent from the study.
The two populations were comparable in terms of age, preoperative visual acuity, stage and size of the drusen, as well as the grade of cataract.
The total light exposure intensity during surgery was 12 times lower in the Ngenuity®* group (3938.3 lux ± 4208.0) compared to the standard group (47141.9 lux ± 18468.2) p < 0.001.
There was no significant change in retinal response ERG b-wave amplitude at V2 from baseline between the two groups. However, the latency time of the b-wave was more prolonged in the SOM group.
No differences were found with the other criteria between the two groups

Conclusions

Digital visualization significantly decreases the light exposure intensity in cataract surgery, with particular interest for patients with macular drusen.
The latency time of the b-wave was shorter in patients operated under low light exposure, which could reflect a quicker recovery. Despite the lack of significant differences in other parameters evaluated in our series, larger studies are needed to demonstrate the potential of this technology to prevent retinal light toxicity during cataract surgery