A Randomized Controlled Study Of Postoperativevisual Perceptual Training In Unilateral Cataract Surgery: Functional And Electrophysiological Outcomes

This trial aims to evaluate the efficacy of Gabor patch-based visual perceptual training integrated with lateral masking technology in postoperative visual performance and neural adaptation among patients undergoing unilateral cataract surgery with intraocular lens (IOL) implantation.

This randomized controlled trial enrolled 30 patients (aged 40–80 years) undergoing unilateral phacoemulsification with IOL implantation at an ophthalmic clinical center from July 2024 to December 2024. Participants were randomly allocated to either the visual perceptual training group or the control group. Exclusion criteria included coexisting ocular pathologies, systemic diseases affecting vision, or cognitive impairment. Ethical approval was secured from the institutional review board.

The training group underwent 12 sessions (30min/session, 4/week) using the RevitalVision system, integrating Gabor patches and lateral masking to stimulate cortical neuroplasticity through AI-adapted visual discrimination, motion detection, and multi-object processing tasks. Assessments at baseline and 3 weeks included: functional metrics (monocular/binocular logMAR, glare/no-glare contrast sensitivity [CSV-1000E], MTF/Strehl ratio [OPD-Scan III]); electrophysiology (VEP latency/amplitude [Espion]); and patient-reported outcomes (Catquest-9SF [vision-related quality of life], MMSE [cognition]). Data were analyzed using paired/independent t-tests or non-parametric tests (SPSS v25, p<0.05).

After training, the training group (n=15) showed superior binocular UDVA (-0.050 vs. 0.000 logMAR, p=0.011) and BCVA (-0.100 vs. 0.000 logMAR, p=0.004) vs. controls (n=15). Contrast sensitivity improved at 6 cpd under photopic (2.05±0.19 vs. 1.80±0.18 log units, p=0.025) and mesopic non-glare conditions (median 2.07 vs. 1.84, p=0.019). VEP N135-P100 amplitude increased post-training (23.84→27.04μV, p=0.039) in the training group, with no changes in controls. Baseline MTF area ratio/Strehl ratio and vision-related quality of life/cognition scores (Catquest-9SF, MMSE) were comparable (p≥0.05). No adverse events occurred.

Gabor patch-based perceptual training with lateral masking can significantly improve functional vision (UDVA, BCVA, mid-spatial-frequency contrast sensitivity) and cortical neuroplasticity (elevated N135-P100 amplitude) in patients undergoing unilateral cataract surgery with intraocular lens (IOL) implantation. Electrophysiological changes suggest enhanced neural adaptation, potentially accelerating cortical adjustment to binocular vision alteration in patients with unilateral IOL implantation by visual training.