Presbyopia can have different corrections for each individual, but there is no one-size-fits-all solution suitable for everyone

When discussing lens replacement surgery for presbyopia correction, communication with patients becomes crucial. The uncertainty surrounding post-treatment vision often leads to difficult conversations. Managing patient expectations is a challenge, and making the right choice from the extensive array of available options is not always straightforward.

As Clinical Development Director at 2EyesVision, Irene Sisó Fuertes recognizes the complexities clinicians face in selecting the most suitable intraocular lens (IOL) for their patients. In this video, Irene provides insights into the diverse possibilities offered by the SimVis Gekko visual simulator.

SimVis Gekko is a revolutionary technology designed to address these challenges. It offers an accurate and personalized experience of premium presbyopic corrections before actual implantation. The device is programmable, binocular, head-mounted, wireless, and cloud-based, providing a see-through, real-world visual experience with a wide field of view. The technology behind SimVis Gekko replicates the optical performance of real IOLs at all distances. A meticulous 3-step validation process ensures accuracy:

• First, we gather information about the optical performance through focus of a specific IOL design;
• Next, computational validation is conducted to compare the through-focus performance of our simulation to that of the IOL;
• This is followed by on-bench validation;
• Finally, a clinical evaluation on presbyopic volunteers.

The SimVis Gekko lens menu boasts a diverse range of IOL simulations, including monofocal, enhanced monofocal, extended depth of focus, increased range of focus, bifocals, trifocals, and more, from various manufacturers. Each addition to the menu undergoes clinical validation, ensuring accuracy comparable to real-world outcomes.

The defocus curves, measured in healthy presbyopic volunteers, demonstrate the performance of each lens simulation. Despite variability across subjects, a common trend within each lens is observed. Clinical validation involves comparing these results to data from patients who have undergone actual IOL implantation.

SimVis Gekko’s extensive menu allows clinicians to choose which lenses to “taste” for their patients. Understanding the performance of multiple IOLs for a single subject is invaluable. Patient education is playing here a key role through visual experiences.

Exploring the performance of various IOLs for a single individual is fascinating. In the first grapgh, this patient tried 7 lenses, showing consistent performance at far and intermediate distances, with notable differences at near. However, this is just one example. In the second picture, two different subjects experienced the same lenses via SimVis Gekko, resulting in varying performances. Subject #5 demonstrated enhanced intermediate vision with the EDOF IOL in red compared to the monofocal simulation in black, while trifocal IOLs showed superior visual acuity at near distances than the EDOF. Conversely, subject number #1 exhibited a naturally increased depth of field, evident in the monofocal simulation in black, leading to no significant performance differences among the lenses. These findings highlight the importance of allowing patients to explore various options before surgery, as individual preferences and visual experiences significantly influence outcomes, even with identical lenses.

The visual simulator can also simulate presbyopic LASIK patterns or multifocal contact lenses

Moreover, SimVis Gekko goes beyond IOL simulations; it can also simulate presbyopic LASIK patterns or multifocal contact lenses. Through a non-invasive personalized assessment, hundreds of patients worldwide have already benefited from this innovative technology.

In conclusion, SimVis Gekko offers a unique opportunity to navigate the vast IOL menu. It allows for preoperative evaluation of the performance and patient reaction to different IOLs, streamlining the decision-making process. The accuracy and scientific validation of the IOL simulations make SimVis Gekko an invaluable tool in the field, bringing the most relevant IOL options directly to your table.

Do you want to know more about this visual simulator?

Exploring the potential: diverse applications and patient benefits of visual simulators in ophthalmology

A visual simulator for ophthalmology is a technologically advanced tool that accurately replicates various visual conditions and ocular pathologies (like near vision loss or age-related vision loss and blurry vision). These simulators provide ophthalmology professionals with an interactive and educational platform to understand, diagnose, and treat different visual problems in a clinical environment. Here are some additional patient-focused advantages of using visual simulators:

1. Patient Education

Visual simulators help ophthalmologists educate patients about the different IOL options for presbyopia correction available in the market.

2. Improved Clinician-Patient Communication

Visual simulators facilitate effective communication between ophthalmologists and patients. By letting patients experience the real world through different intraocular lens designs, the simulator helps the clinician explain complex concepts in a more accessible manner, fostering clear communication and shared decision-making.

3. Expectation Management

Visual simulators play a crucial role in managing patient expectations before ocular surgery. By providing a virtual representation of the anticipated surgical outcomes, patients can have a more realistic understanding of what to expect post-surgery. This helps prevent unrealistic expectations and potentially ensures higher patient satisfaction.

4. Post-Surgery Patient Satisfaction

Visual simulators can contribute to post-surgery patient satisfaction by allowing patients to visualize and compare their pre- and post-operative visual capabilities. Patients can see the positive impact of the surgery on their vision preoperatively, which could reinforce their trust in the chosen treatment and potentially lead to higher levels of satisfaction.

5. Research

Additionally, visual simulators have a significant impact on research and development within the field of ophthalmology. Researchers and medical device manufacturers can use these simulators to evaluate the efficacy of innovative treatments, and even to refine the design of advanced ocular implants. These ongoing research and development contribute to continuous advancements in the field, leading to improved outcomes for patients.

Today visual simulators for ophthalmology contribute to patient education, improved clinician-patient communication, expectation management, and post-surgery satisfaction. 

The need for reading glasses because of near vision loss, age-related vision loss, age-related blurry vision, reading vision loss or presbyopia are shared challenges. Visual simulators become crucial tools in addressing these issues, making it easier for everyone to learn about their eyes and talk with doctors. This worldwide challenge emphasizes the ongoing need for improvements in eye care, benefiting everyone dealing with vision challenges.

What type of visual simulator should you use for presbyopia and cataracts before treatment?

SimVis Gekko is the only portable, programmable, see-through device where you can test different commercial lenses from each brand before surgery or treatment.

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Types of IOLs

These are the most commonly implanted lenses worldwide and are used to replace the natural crystalline lens to correct cataracts and/or presbyopia, also known as age-related need for reading glasses.

Currently, there are four main groups of IOLs: monofocal, enhanced monofocal, extended depth of focus (EDOF), and multifocal lenses. All these lenses designs replace the human lens providing different kind of vision.

1. Monofocal

These are the most common lenses and usually correct only distance vision. They are commonly used in patients undergoing cataract surgery who do not mind wearing glasses for near and intermediate vision.

2. Enhanced Monofocal

Enhanced monofocal IOLs usually have a similar distance performance when compared to convenntional monofocal IOLs, however they often provide improved unaided intermediate vision relative to conventional monofocal IOLs.

3. EDOF

The term extended depth of focus (EDOF) is commonly used to describe lenses that use different techniques to provide an increased range of focus compared to a standard monofocal intraocular lens (IOL).

4. Full-Range (Trifocal)

These lenses provide good vision for distance, near, and intermediate range (computer, car dashboard). There is a wide variety of designs available in the market. They are currently considered a good option for replacing the human lens for some individuals, although they may be more prone to initially cause unwanted visual phenomena such as halos, starbursts, and glare, which patients usually adapt to within months.

Every person is unique, one lens can be suitable for one individual but not necessarily for another.

Is it possible to try different lenses of each type before treatment to see which one is the best option for me?

Yes, ask your ophthalmologist or referring specialist to perform a test with SimVis Gekko, a visual simulator that allows a real experience of each lens before surgery.

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Human eye

The human eye is a complex and sophisticated organ responsible for vision, allowing us to perceive and interpret the world around us. It is a spherical structure located in the eye socket of the skull, composed of various parts including the cornea, iris, pupil, lens, retina, and optic nerve.

Basically, the eye works by capturing light and transforming it into electrical signals that are transmitted to the brain, where they are interpreted and processed into visual images.

The human eye is a remarkable example of the complexity and precision of biological systems.

Anatomy of the eye

The anatomy of the human eye is complex and made up of several different structures and parts that work together to provide vision. Here is a brief overview of the main parts of the eye:

1. Cornea: The cornea is the clear outermost layer of the eye that covers the iris, pupil, and anterior chamber. It plays a vital role in focusing light onto the lens.
2. Iris: The iris is the colored part of the eye that surrounds the pupil and controls the amount of light entering the eye by adjusting the size of the pupil.
3. Pupil: The pupil is the black circular opening at the center of the iris, which regulates the amount of light entering the eye.
4. Lens: The lens is a clear, flexible structure located behind the iris and pupil, which helps to focus light onto the retina.
5. Retina: The retina is the layer of light-sensitive cells at the back of the eye that converts incoming light into electrical signals that are sent to the brain via the optic nerve. It contains two types of photoreceptor cells called rods and cones, which respond to different levels of light and color.
6. Optic nerve: The optic nerve is a bundle of nerve fibers that carries the electrical signals from the retina to the brain, where they are interpreted and processed into visual images.
7. Sclera: The sclera is the white outer layer of the eye that protects the eyeball and maintains its shape.
8. Choroid: The choroid is the layer of blood vessels between the sclera and the retina that provides oxygen and nutrients to the eye.
9. Ciliary body: The ciliary body is a ring-shaped muscle that controls the shape of the lens and helps to adjust focus.
10. Aqueous humor: The aqueous humor is a clear fluid that fills the front part of the eye and helps to maintain its shape and pressure.
11. Vitreous humor: The vitreous humor is a clear gel-like substance that fills the back part of the eye and helps to maintain its shape and support the retina.

Structure of the eye. Source: OpenStax College via Wikimedia Commons

Functions of the eye

The eye is a complex organ that performs several critical functions that allow us to see the world around us. Here are the main functions of the eye:

1. Refraction of light: The cornea and lens work together to bend and focus incoming light onto the retina at the back of the eye. This is the first step in the process of vision.
2. Sensing light: The retina contains photoreceptor cells called rods and cones that respond to different levels of light and color. These cells convert the incoming light into electrical signals that are sent to the brain via the optic nerve.
3. Image formation: The brain uses the electrical signals from the retina to create the visual images that we see. These images are formed by the brain’s interpretation of the patterns of electrical signals sent from the retina.
4. Color perception: The cones in the retina are responsible for color vision, allowing us to perceive and differentiate between different colors.
5. Depth perception: The eyes work together to provide depth perception, allowing us to judge the distance and position of objects in the world around us.
6. Accommodation: The ciliary body and lens work together to adjust the focus of the eye, allowing us to see objects at different distances.
7. Regulation of light: The iris adjusts the size of the pupil to regulate the amount of light entering the eye, helping us to see clearly in different lighting conditions.

Overall, the eye is an incredibly sophisticated organ that performs several critical functions to allow us to see and interact with the world around us.

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