Impact Of Preoperative Visual Simulation On Clinical Decision-Making And Patient Counseling: A Multicenter Real-World Clinician Survey

Published 2026 - 44th Congress of the ESCRS

Reference: FP01.01 | Type: Free paper | DOI: 10.82333/njq4-dh68

Authors: Dr Nicolas Alejandre ¹ , Dr Fernando Arasanz ² , Dr Camille Bosc ³ , Dr Julien Combes* ⁴ , Dr Alberto de Castro-Asarta ⁵ , Dr Carlos Gutiérrez-Amorós ⁶ , Dr Jorge Henriques ⁷ , Dr Belén López ⁸ , Dr Mohammad Neal ⁹ , Dr Luis G. Paparo ¹⁰ , Dr Raquel Salvador-Roger ¹¹

¹Instituto de Microcirugía Ocular (IMO Madrid) ,Madrid,Spain, ²Arasanz Laser Vision,Buenos Aires,Argentina, ³Clinique Jules Verne,Nantes,France, ⁴Centre Monticelli Paradis,Marseille,France, ⁵Clínica Oftalmológica Castro,Valencia,Spain, ⁶Vista Gutiérrez Amorós Oftalmólogos,A Coruña,Spain, ⁷Department of Ophthalmology,Unidade Local de Saúde (ULS) de Coimbra,Coimbra,Portugal;Clinical Academic Center of Coimbra,Coimbra,Portugal;Faculty of Medicine,University of Coimbra,Coimbra,Portugal, ⁸Panama Eye Center,Panama,Panama, ⁹Anaheim Eye Institute,Anaheim,United States, ¹⁰VisuaLaser,Cali,Colombia, ¹¹2EyesVision SL,Madrid,Spain

Purpose

To evaluate the perceived impact of preoperative binocular visual simulation on clinical confidence, patient counseling, shared decision-making, and intraocular lens (IOL) selection in routine cataract and refractive lens exchange practice, based on clinician-reported real-world experience.

Setting

Multicenter survey of ten ophthalmological clinics incorporating binocular visual simulation (SimVis Gekko) into routine preoperative counseling for presbyopic patients.

Methods

A structured 24-item questionnaire was completed by the ten earliest adopters of SimVis Gekko in clinical practice as a decision aid during IOL counseling. The survey was organized into thematic sections addressing clinical confidence, shared decision-making, patient understanding, expectation management, consultation workflow, usability, and conversion rates. Most items were rated using a 5-point Likert scale, complemented by percentage-based estimations, multiple-choice questions, and open-ended responses. This exploratory clinician survey assessed the perceived impact of visual simulation on clinical decision-making and surgical planning. Descriptive analysis was performed.

Results

All respondents (100%) reported weekly use; 70% used the device in >25% of preoperative consultations. Its use was focused on cataract and refractive lens exchange procedures. All clinicians reported increased confidence in recommending IOL strategies and improved explanation of visual trade-offs. Simulation prompted modification of the initial IOL plan in at least some cases for all respondents; 50% reported changes >20% of consultations. 80% reported reduced postoperative dissatisfaction and increased premium IOL conversion (estimated +5% to >40%). 40% reported unchanged or reduced consultation time despite 10-20 minutes of device use; in 10% use took <5 minutes. Mean satisfaction was 9/10, highest among users with >12 months’ experience.

Conclusions

In this real-world multicenter clinician survey, preoperative binocular visual simulation was consistently associated with greater clinical confidence, improved communication of visual trade-offs, and frequent modification on initial IOL selection. The tool supported shared decision-making and expectation alignment, particularly in borderline premium IOL candidates. Most clinicians reported increased premium conversion rates and reduced postoperative dissatisfaction, while also identifying unsuitable candidates more effectively. Despite occasional increases in consultation time, overall satisfaction was high, especially among experienced users, suggesting a positive learning curve and meaningful clinical value.