Visual simulators replicate vision with multifocal lenses

Abstract

Adaptive optics (AO) visual simulators based on deformable mirrors, spatial light modulators or optotunable lenses are increasingly used to simulate vision through different multifocal lens designs. However, the correspondence of this simulation with that obtained through real intraocular lenses (IOLs) tested on the same eyes has not been, to our knowledge, demonstrated. We compare through-focus (TF) optical and visual quality produced by real multifocal IOLs (M-IOLs) -bifocal refractive and trifocal diffractive- projected on the subiect’s eye with those same designs simulated with a spatial light modulator (SLM) or an optotunable lens working in temporal multiplexing mode (SimVis technology). Measurements were performed on 7 cyclopleged subjects using a custom-made multichannel 3-active-optical-elements polychromatic AO Visual Simulator in monochromatic light. The same system was used to demonstrate performance of the real IOLs, SLM and SimVis technology simulations on bench using double-pass imaging on an artificial eye. Results show a general good correspondence between the TF performance with the real and simulated M-IOLs, both optically (on bench) and visually (measured visual acuity in patients). We demonstrate that visual simulations in an AO environment capture to a large extent the individual optical and visual performance obtained with real M-IOLs, both in absolute values and in the shape of through-focus curves.

Optical and Visual Quality With Physical and Visually Simulated Presbyopic Multifocal Contact Lenses

“…The procedure, and the resultant SimVis simulation, has already been validated in intraocular lenses with sophisticated surface geometries (zonal refractive or diffractive). 20 Consequently, novel MCLs could be visually simulated with SimVis, even before they are manufactured.…”

“…These features have allowed for the concept to be translated into a binocular, wearable clinical device (SimVis Gekko). Previous studies have proven the capability of the SimVis technology to replicate vision with real refractive segmented IOLs and trifocal diffractive IOLs 20 and a high correspondence between preoperative vision with SimVis Gekko and postoperative vision with the real implanted multifocal IOL. 26 The ability of SimVis technology to allow subjects to noninvasively experience multifocal vision is highly useful before intraocular lens implantation, given that a lack of tolerance to implanted multifocal IOLs may require surgical explantation.…”

“…Adaptive optics (AO) visual simulators are particularly attractive to test vision in subjects with new optical designs before delivering or even manufacturing a lens. 15 – 19 AO-simulations of new corrections enable investigation of interactions between a subject's optics and a given correction, characterization of differences across corrections, and eventually selection of the correction that optimizes perceived visual quality and performance in subjects 20 . 20 In previous studies, 15 , 16 we have simulated diverse novel refractive multifocal designs (concentric and asymmetric), as well as commercial refractive and diffractive Intraocular lenses (IOLs) using a spatial light modulator (SLM) integrated in an AO system, and demonstrated equivalency between the patient's vision through the simulated lenses and physical lathe-manufactured phase-plates or physical IOLs in a cuvette.…”

Bifocal and Multifocal Contact Lenses for Presbyopia and Myopia Control

“…However, unlike theoretical models, experimental visual simulators incorporate both ocular optics and neural factors, showing visual testing of different multifocal patterns and offering patients a direct visual experience before fitting a specific multifocal contact lens design. ese simulators are based on adaptive optics elements (deformable mirrors or spatial light modulators [51][52][53]) or temporal multiplexing (e.g., SimVis technology [54][55][56]) and work by projecting the theoretical multifocal pattern design onto the patient´s pupil plane, allowing us to evaluate the effect of different distance-near pupillary distribution and to test directly the visual performance. Recent studies have demonstrated that the through-focus visual performance with the same multifocal pattern varied across individuals, indicating that the specific performance of the design is highly patient-specific since not all patients tolerate well the out-of-focus image components in simultaneous vision [55].…”

VioBio lab adaptive optics: technology and applications by women vision scientists

“…An alternative simulation of multifocal patterns is that used by the SimVis technology (https://www.2eyesvision.c om/es/simvis/), operating under the principle of temporal multiplexing of optotunable lenses, 10 which has been used to mimic commercial intraocular lenses, with several advantages over previous simulators: it is see-through, allows a wide field of view, and is very compact (a current commercial instrument based on this technology is binocular and wearable). In a recent study 11 an optotunable lens (SimVis) and a cuvette with a real segmented intraocular lens were placed in pupil conjugate planes in the testing channel of AOII. Through-focus visual acuity was measured with either simulator (SimVis, SLM or real lens in 2ANG stands for bifocal angularly segmented intraocular lens (IOL); 2RAD stands for bifocal radially segmented IOL; 3ANG stands for a 3-zone angularly segmented IOL; 3RAD stands for 3-zone radially segmented IOL; 4ANG stands for a 4-zone angularly segmented IOL; 4RAD stands for 4-zone radially segmented IOL; Bi-R stands for bifocal refractive IOL and Tri-D stands for trifocal diffractive IOL.…”