Lens- And Distance-Specific Repeatability Of Visual Acuity Outcomes Using An Intraocular Lens Simulator
Published 2026 - 44th Congress of the ESCRS
Reference: PP26.12 | Type: Free paper | DOI: 10.82333/ekah-nz76
Authors: Dr Grzegorz Labuz* 1 , Dr Fatima Cuellar 2 , A/Prof. María S. Millán 3 , A/Prof. Gerd Auffarth 1
1Department of Ophthalmology, David J. Apple Center for Vision Research,University Hospital Heidelberg,Heidelberg ,Germany, 2Department of Ophthalmology, David J. Apple Center for Vision Research,University Hospital Heidelberg,Heidelberg,Germany;Universitat Politècnica de Catalunya,Group of Applied Optics and Image Processing,Terrassa,Spain, 3Universitat Politècnica de Catalunya,Group of Applied Optics and Image Processing,Terrassa,Spain
Purpose
SimVis Gekko (2EyesVision) is an intraocular lens (IOL) simulator that enables patients to experience various IOL designs by reproducing their optical properties. While the agreement between SimVis Gekko simulations and postoperative outcomes has been investigated, data on the repeatability of its IOL simulations and their consistency across lenses and viewing distances are scarce. This study aimed to assess the repeatability of visual acuity outcomes obtained with SimVis Gekko across three consecutive visits.
Setting
David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Germany.
Methods
Thirteen phakic subjects were evaluated under cycloplegia using the SimVis Gekko device. At each visit, six IOLs were simulated in randomized order. The following models were included: RayOne EMV (Rayner), Tecnis Eyhance, Tecnis Symfony, and Tecnis Synergy (all from J&J Vision), as well as Vivity and PanOptix (both from Alcon). To assess reproducibility, subjects were examined on three separate visits. Binocular logMAR visual acuity was measured at far, 100 cm, 67 cm, and 40 cm. Statistical analysis included intraclass correlation coefficients (ICC) to compare repeatability between IOLs and test distances.
Results
ICCs for logMAR repeatability varied by IOL and distance. At 40 cm, ICCs ranged from moderate (0.62; Eyhance) to excellent (0.91; PanOptix). At 67 cm, ICCs were consistently moderate (0.62–0.73; Vivity–Symfony). At 100 cm, repeatability was lowest overall, ranging from poor (0.44; RayOne EMV) to good (0.76; Vivity). At far, all IOLs showed good-to-excellent repeatability (0.70–0.88; Symfony–RayOne EMV). Across positions, PanOptix showed the highest and most consistent repeatability (0.72–0.91), followed by Vivity and Synergy (0.62–0.80 and 0.70–0.76, respectively).
Conclusions
SimVis Gekko demonstrated overall moderate-to-excellent repeatability of simulated visual acuity across lenses and viewing distances, supporting its use for preoperative counseling and IOL selection. Repeatability was highest at near and far and lowest at 100 cm. Among the tested designs, IOLs providing an extended range of vision showed less variable simulated outcomes than enhanced monofocal IOLs, which exhibited lower repeatability at intermediate and near distances.