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  • 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


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


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

    For full disclosures and the disclosure key, see below.

    Full Financial Disclosures

    Dr. Hwang Catholic University of Korea: P; Ministry of Education, Republic of Korea: S.

    Dr. Manche Alcon: S; Allergan: S; Avedro: C,S; Carl Zeiss Meditec: S; Johnson & Johnson Vision: C,S; NIH: S; Novartis: S; Placid0: P,S; Presbia: S; Research to Prevent Blindness: S; RxSight: U,S; VacuMed: P,S.

    Dr. Ten Hulzen None.

    Dr. Wykoff Adverum: C,S; Aerie: S; Aldeyra: S; Alimera Sciences S; Allergan: C; Apellis: C,S; Bausch + Lomb: C; Bayer: C,S; Bionic Vision Technologies: C; Boehringer Ingelheim: S; Chengdu Kanghong: C,S; Clearside Biomedical: C,S; Eye­Point: C; Gemini Therapeutics: S; Genentech: C,S; Graybug Vision: S; Gyroscope: C,S; Ionis Pharmaceutical: S; IVERIC Bio: C,S; Kato: C; Kodiak Sciences: C,S; LMRI: S; NGM Biopharmaceuticals: C,S; Novartis: C,S; OccuRx: C; Ocular Therapeutix: C; ONL Therapeutics: C,O; Opthea: C,S; Ox­urion: C,S; Palatin: C; PolyPhotonix: C,O; RecensMedical: C,O,S; Regeneron: C,S; RegenXBio: C,S; Roche: C,S; Sant­en: S; Takeda: C; Visgenx: C,O: Xbrane Biopharma: S.

    Disclosure Category



    Consultant/Advisor C Consultant fee, paid advisory boards, or fees for attending a meeting.
    Employee E Hired to work for compensation or received a W2 from a company.
    Employee, executive role EE Hired to work in an executive role for compensation or received a W2 from a company.
    Owner of company EO Ownership or controlling interest in a company, other than stock.
    Independent contractor I Contracted work, including contracted research.
    Lecture fees/Speakers bureau L Lecture fees or honoraria, travel fees or reimbursements when speaking at the invitation of a commercial company.
    Patents/Royalty P Beneficiary of patents and/or royalties for intellectual property.
    Equity/Stock/Stock options holder, private corporation PS Equity ownership, stock and/or stock options in privately owned firms, excluding mutual funds.
    Grant support S Grant support or other financial support from all sources, including research support from government agencies (e.g., NIH), foundations, device manufacturers, and\or pharmaceutical companies. Research funding should be disclosed by the principal or named investigator even if your institution receives the grant and manages the funds.
    Stock options, public or private corporation SO Stock options in a public or private company.
    Equity/Stock holder, public corporation US Equity ownership or stock in publicly traded firms, excluding mutual funds (listed on the stock exchange).


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