Pre-operative simulation of post-operative multifocal vision

Area of Science:

• Ophthalmology
• Optics
• Visual Science

Background:

• Multifocal intraocular lenses (MIOLs) are widely used to correct presbyopia.
• Predicting visual outcomes with MIOLs pre-operatively remains challenging.
• Understanding patient perception of multifocal correction is crucial for surgical planning.

Purpose of the Study:

• To evaluate the accuracy of visual simulation technologies in predicting vision with multifocal intraocular lenses.
• To compare pre-operative simulated MIOL vision with post-operative actual MIOL vision in the same patients.
• To assess the reliability of adaptive optics and clinical simulators for MIOL performance prediction.

Main Methods:

• Two simulation platforms were employed: an adaptive optics (AO) system (SLM and SimVis) and a wearable clinical simulator (SimVis Gekko).
• A trifocal diffractive MIOL (POD F, FineVision) was simulated pre-operatively and implanted post-operatively in eight patients.
• Through-focus decimal visual acuity (TF VA) was measured monocularly (AO) and binocularly (clinical simulator).

Main Results:

• Pre-operative visual simulations closely predicted post-operative TF VA performance.
• The average RMS difference between simulated and actual MIOL TF VA curves was low (0.06 ± 0.01).
• TF curves showed high correlation between simulators and with actual implanted MIOL results (rho = 0.889 and 0.853, respectively).

Conclusions:

• Visual simulation technologies are effective tools for predicting visual performance with MIOLs.
• Both AO systems and clinical simulators provide reliable pre-operative predictions of MIOL outcomes.
• Pre-operative visual simulations demonstrate good agreement with post-operative patient data, aiding in MIOL selection and patient counseling.