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Robert Rosen, Henk A Weeber, Carmen Canovas, Aixa Alarcon, Patricia Piers; Spectacle independence of pseudophakic patients predicted from preclinical data. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3714.
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© ARVO (1962-2015); The Authors (2016-present)
Intraocular lens (IOL) designs are often compared and evaluated using preclinical data. One important feature of modern IOLs is that patients may become less dependent on spectacle use. We have previously presented a Bayesian big data model for predicting rates of spectacle independence from clinical defocus curves and compared it against patient reported spectacle independence. The current study extends this model to preclinically simulated defocus curves for currently available as well as novel IOL designs.
The Bayesian model for predicting spectacle independence from through focus visual acuity curves was constructed based on clinical data and not altered. In this study, spectacle independence is defined as the percentage of patients that report not using spectacles for any distance. The input for the model is the visual acuity at seven defocus positions between -3D and 0D. Predicted through focus visual acuity curves were calculated from preclinical optical bench measurements in an eye model with average spherical and chromatic aberration using white light and a 3 mm pupil following a method described in the literature. The different IOL designs compared included a standard monofocal design, a monofocal lens designed to improved intermediate vision, and presbyopiacorrecting designs based on bifocal, multifocal, and extended depth of focus technology.
For presbyopia-correcting IOLs, the average prediction error was 5% and the same as when using clinical through focus visual acuity curves. Including monofocal IOLs increased the average prediction error model when using preclinical data to 11%. For bifocal designs the predicted rates of spectacle independence increased with increasing add power. Going from +2.75D to 3.25D resulted in a predicted increase of 11%, and increasing the add power further to 4D gave an additional 12% increase. As expected, the standard monofocal design resulted in the lowest rate. The monofocal design with improved intermediate had a rate that was 9% higher than the standard monofocal, but it was still well below the rates for extended depth of focus designs. Evaluation of experimental designs indicate that spectacle independence can be increased over those achieved with currently available IOLs.
Through focus visual acuity curves calculated form preclinical data can be used to predict rates of spectacle independence to evaluate IOL designs.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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