Cortical Stimulation Using Gabor Patches Improves Vision And Contrast Sensitivity In Dissatisfied Patients With Multifocal Intra Ocular Lenses: Results Of Randomized Controlled Trial
Published 2025 - 43rd Congress of the ESCRS
Reference: PP19.07 | Type: Free paper | DOI: 10.82333/78ks-1077
Authors: Stefan Georgiev* 1 , Manuel Ruiss 1 , Lisa-Maria Liebhart 1 , Johannes Zeilinger 1 , Caroline Pilwachs 1 , Oliver Findl 1
1Ophthalmology Department, Hanusch Hostpital Vienna,Vienna Insitute for Research in Ocular Surgery,Vienna,Austria
Purpose
To evaluate patient-specific, computer-based perceptual visual therapy (PL) regime using Gabor patches for improving vision & contrast sensitivity function(CSF) in patients not satisfied after multifocal IOL (MF-IOL) implantations.
Setting
A prospective, controlled-randomized, open-label study.
Methods
A prospective, controlled-randomized, open-label study. Adults (50-70 yrs) with uneventful MF-IOL implantation, 4-24 weeks post-surgery, BCVA worse than 20/40 with sub-optimal Contrast(CSF), complaining about vision quality were randomized in 2:1 ratio into Treatment(G1), in which computer-based perceptual therapy using Gabor patches amidst co-linear flankers was employed and Control(G2) arms. The study had 2 phases (screening + therapy periods(PL). Mid-training (Post 20 sessions), 40 training sessions, and post-therapy follow-up by 6 months were evaluated for improvements in BCVA distance & near (ETDRS) & CSF at spatial frequencies of 3, 6,12,18 CPD with FACT sine wave grating system, using Friedman tests for repeated measures.
Results
30 cases were randomized into a 2:1 ratio into treatment and control arms. 16 Trifocals(PanOptix), 14 Bifocals(Tecnis). The average improvement after treatment is 2.5 lines in Log Mar in the Treatment arm (p<0.0001), whereas no significant improvements were observed among the controls.
83% improvement in Contrast Sensitivity (CSF at 3,6,12 & 18 CPD) was observed in the Treatment Group(G1, p<0.0001) whereas no significant improvements amongst the controls using Friedman repeated measure tests.
Conclusions
Sequential, patient-specific, cortical stimulation improved vision & contrast (CSF) in dissatisfied MF-IOL patients with visual deficiencies & acts as proof of concept of improving neural connections at cortical levels. Phaco surgeons could consider it as a post-operative therapeutic adjuvant, in MF-IOL with visual deficiencies & reduced contrast.
The key to optimizing vision following MF-IOL lies in addressing the brain as well as the eyes.