Methods: Twenty-three presbyopes with clear crystalline lenses were evaluated binocularly using SimVis Gekko visual simulator (2EyesVision).Six commercial multifocal and EDOF IOLs were simulated using the principle of temporal multiplexing: AcrySoft IQ PanOptix, FineVision POD F, AT Lisa tri, Tecnis Symfony, AcrySoft IQ Vivity, and AT Lara. Defocus visual acuity (DFVA) curves were measured for each simulated IOL under photopic conditions. Simulated IOLs were programmed from published through-focus modulation transfer function data at 15 cycles/degree. Defocus visual acuity curves through simulated IOLs were compared to average postoperative DFVA data from peer-reviewed publications (108–322 pseudophakic patients per IOL).

Results: Simulated IOLs accurately reproduced on-bench optical profiles in terms of through-focus Visual Strehl Ratio (cross-correlation >0.98, RMSE <0.04). Defocus visual acuity curves through simulated IOLs closely matched postoperative curves in subjects implanted with the corresponding IOL (cross-correlation ≥0.94, RMSE ≤0.07), with far vision differences ≤0.09 logarithm of the minimum angle of resolution (logMAR). Discrepancies were largest at high near vergences (up to 0.17 logMAR). Trifocal IOLs (PanOptix, FineVision, AT Lisa) expanded DOF by ∼1.5 D compared with monofocal IOLs, while EDOF IOLs (Symfony, Vivity, AT Lara) expanded DOF by ∼0.7 D. Visual simulations replicated relative gains at intermediate/near and degradations at far, consistent with clinical outcomes in implanted patients. Intersubject variability observed in simulations

Purpose: To quantify the halo size produced by simulated multifocal and extended depth of focus (EDOF) intraocular lenses (IOLs) using a novel psychophysical method, and to compare the results with an established halo assessment tool, computational simulations, and subjective bothersomeness scores.

Methods: Ten participants were each presented with ten IOL designs (three trifocals, three EDOFs, three bifocals, and one monofocal) simulated using SimVis Gekko visual simulator (2EyesVision, Spain). Halo size was quantified using both the established Halo V1.0 software and a custom-developed scrolling method designed for rapid halo assessment. Results were compared with computational predictions derived from Fourier optics. Perceived visual disturbance was evaluated using a shortened version of the Assessment of Intra Ocular Lens Implant Symptoms questionnaire.

Results: Trifocals produced larger halos than EDOFs, whereas the monofocal generated the smallest. Measurements obtained with Halo V1.0 and scrolling method were highly correlated (r = 0.99) and showed strong agreement with computational estimations (r > 0.92). Halo size increased with IOL addition power by 5 arcmin/diopter. The scrolling method required less time (29.6 ± 16.2 vs. 283 ± 1.7 seconds) and exhibited lower variability (1 ± 0.8 vs. 5.4 ± 5.8 arcmin) compared to Halo V1.0. Subjective disturbance scores correlated strongly with measured halo (r > 0.98).

Conclusions: SimVis Gekko emulates halo phenomena associated with different IOL designs. The custom scrolling method provides fast, reliable halo assessment with potential for research and clinical application.

Translational Relevance: Findings support integrating preoperative halo simulation and rapid psychophysical evaluation to enhance personalized IOL selection and patient counseling.