Novel Simulator Enables Multifocal IOL Testing Before Surgery

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In an effort to improve satisfaction rates in patients who receive multifocal IOLs, researchers in Ko­rea have developed an IOL simulator to assess the per­formance of the IOLs before surgery actually occurs.¹

“Our device successfully simulated how the world appears to patients with multifocal IOLs,” said Ho Sik Hwang, MD, PhD, at the Catholic University of Korea in Seoul. “By allowing patients to try different lenses be­fore surgery, the simulator may help ophthalmologists select the appropriate multifocal IOL for their patients and improve patient satisfaction after cataract surgery.”

A wearable mobile option. The IOL simulator con­sists of a bi-concave lens, a commercially available IOL, a lens tube, a spacer, and a wet cell. The device is mounted on a trial lens frame through an adapter. Dr. Hwang explained that this setup allows the trial lens frame containing the IOL simulator to be worn like glasses. “Because the device is mobile and a concave lens was used instead of a convex lens, the field view vertically and horizontally remained unaltered. Conse­quently, patients wearing the trial lens frame can walk around and experience their surroundings in real time through the IOL simulator,” he said.

Study specifics. To evaluate the performance of the simulator, the researchers assessed patient satisfaction with near and distance vision, halos, defocus curve, and near point accommodation in 20 participants between 50 and 70 years of age (median, 61 years). Two IOLs were used: a Tecnis monofocal and a Tecnis bifocal (Johnson & Johnson); neither the examiner nor the patient was informed about which IOL was used during the testing.

Study results. The defocus curve, halo around the light, and satisfaction with near and distance vision in patients wearing the IOL simulator were similar to those in patients who underwent multifocal IOL implantation in published studies, Dr. Hwang said.

However, in this study, patients who tested the multi- focal IOLs were less satisfied than those who tried the monofocal IOLs with distance vision (5.0 vs. 10.0; p < .001) and experienced more halos around the light (9.0 vs. 1.3; p < .001). In contrast, multifocal IOLs pro­vided significantly shorter near point accommodation (24.0 vs. 44.5; p < .001) and higher satisfaction with near vision (7.6 vs. 2.4; p < .001) than did the monofocal IOLs.

Looking ahead. Dr. Hwang noted that further testing of the IOL simulator will be necessary. “We also plan to further improve the device to make it easier to wear and to better seal the wet cell,” he added. With regard to the last point, he explained that because the sealing of the wet cell is imperfect, the saline in the wet cell evaporates and needs to be replaced every three to four hours.

—Christos Evangelou, PhD

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1 Na K-S et al. Transl Vis Sci Technol. 2022;11(3):14.

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Relevant financial disclosures—Dr. Hwang: Catholic University of Korea: P; Ministry of Education, Republic of Korea: S.

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