Clinical validation of simulated multifocal intraocular lenses. SimVis Gekko^TM simulations and reports on pseudophakic patients

Abstract

Purpose : The increasing number of commercially available intraocular lenses (IOLs) makes selecting the optimal design for each patient challenging. SimVisGekko (2EyesVision, Madrid, Spain) is a binocular see-through visual simulator that allows patients to experience the vision with different corrections before surgery. We performed an observational, non-interventional study to compare through focus (TF) performance of simulated multifocal IOLs (MIOLs) through SimVisGekko (SVG) and that reported from patients implanted with the corresponding MIOLs.

Methods : Six MIOLs were programmed in SVG: Symfony (J&J), PanOptix and Vivity (Alcon), FineVision (PhysIOL), ATLisa tri and ATLara (ZEISS). The MIOLs were programmed by optotunable lens temporal multiplexing, using published on bench TF optical quality. Binocular TF logMAR Visual Acuity (TFVA) curves were measured through the simulated designs in 23 presbyopes (15 per lens group, age: 55±5 yo). Postoperative TFVA curves from patients implanted with the same MIOLs were compiled from scientific literature, and compared with the TFVA measured through the SVG-simulated MIOLs. Comparisons were made in terms of TFVA shape similarity (cross-correlation) and Root Mean Square (RMS) difference.

Results : The TFVA shape similarity between simulated and real IOLs was 0.96/0.84/0.90/0.99/0.96/0.97, and the RMS difference was 0.07/0.03/0.04/0.05/0.10/0.12 µm for the Symfony, PanOptix, Vivity, FineVision, ATLisa tri and ATLara IOLs respectively (Figure 1). Simulated TFVA curves and those from implanted patients overlapped their standard deviation in 92% of the defocus and were, on average, statistically similar in 84.3% of the measured dioptric range in 4 of the 6 MIOLs.

Conclusions : The match between TFVA measured in presbyopic subjects through the SVG-simulated MIOLs and pseudophakic patients implanted with the same real MIOLs suggests that commercial corrections can be programmed in SVG using public data and be reliably validated in patients. These findings demonstrate that SVG can accurately reproduce the real vision through the Symfony, PanOptix, FineVision, Vivity, ATLisa tri and ATLara MIOLs, and predict their postoperative performance when used in the clinical practice

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

TFVA curves of SVG simulated MIOLs (colored) and averaged visual performance as obtained from the literature on patients implanted with the corresponding real MIOLs (black)