Wearable see-thru binocular simulator of multifocal and monovision presbyopic corrections

Transcription

1 Wearable see-thru binocular simulator of multifocal and monovision presbyopic corrections Susana Marcos, Aiswaryah Radhakrishnan, Maria Viñas, Clara Benedi, Sara Aissa7, Enrique Gambra, Daniel Pascual, Jose Ramon Alonso-Sanz, Vyas Akondi, Juan Luis Méndez, Xoana Barcala, Carlos Dorronsoro.

2 Disclosures ü 3 Patents on SimVis ü Co-founder of spin-off ü Collaborative agreements in the context of visual simulation with Essilor International, Oculentis, Staar, Hoya, PhysIOL

3 Simultaneous Vision Simulators Adjustable lens Patent PCT 2009 AO systems Patent OEPM 2013 Clinical validations 2015 Manufactured 2014 Wearable prototype 2016

4 Simultaneous vision simulator De Gracia et al. IOVS 2013 Patent applications 2011, 2013

5 Visual Acuity as a function of near add Reference de Gracia et al. IOVS 2013 Low addi7ons (1.5 to 2 D) result in lower visual acui7es and lower leqer contrasts than high addi7ons (3 to 4 D)

6 Short adaptation to multifocal images Pure defocus Simultaneous images Radhakrishan, Dorronsoro, Sawides & Marcos, PLOS One 2014

7 Allowing pacents experience mulcfocality & compare across lens designs ü Increase clinician & patients confidence in multifocal solutions ü Reduce uncertainty ü Increase number of multifocal implants & patient satisfaction

8 Simultaneous Vision Simulators Adjustable lens Patent PCT 2009 AO systems Patent OEPM 2013 Clinical validations 2015 Manufactured 2014 Wearable prototype 2016

9 Technology behind SimVis: Temporal MulCplexing Tunable lens (Optotune, AG) ü Custom high speed ü Electronic driver Temporal multiplexing: ü Scan a 3-diopters (D) addition focus range at 50 Hz ü Static appearance of multifocal retinal images

10 OpCcal characterizacons HS-aberrometry: ü Very linear response of optical power vs voltage (R=0.997) ü High optical quality (RMS<0.05 µm)

11 SimVis Mini (Monocular) 11

12 SimVis Mini Experiments 9 cyclopeged subjects ü No astigmatism ü Far Refraction corrected with instrument 7 corrections simulated: ü Monofocal: 100F 100N 100I ü Bifocal: 50F 50N & 70F 30N ü Trifocal: 33F 33I 33N & 50F 20I 30N

13 Perceived Visual Score test Visual scene containing F, I & N targets Scene overall score (1-5) evaluated at F, I & N distances

14 MulCfocal design preference test Thru Design x Thru Design y or? 6 designs 10 random repetitions 2 AFC Accepted: +1; Rejected: -1 Summed Score Bernouilli Statistics

15 High Contrast Visual Acuity test At F, I & N Randomized E Optotypes High Resolution Display

16 Perceptual Score: Individual subjects Monofocal designs Multifocal designs Near Vision Score 100F 100N 100I Bubble size: Overall score Near Vision Score 50F 50N 70F30N 33F 33I 33N 50F 20I 30N Far Vision Score Far Vision Score 9 subjects, paralyzed accommodation Dorronsoro, Radhakrishan, Alonso-Sanz, Velasco-Ocana, Perez-Merino, OpCca 2016

17 MulCfocal design preference Legend Average Preference Preference: individual subjects ü On average, Trifocal higher preference Dorronsoro et al. OpCca 2016

18 Visual Acuity at different distances Monofocal In focus Out of focus (3D) 0.51 Multifocal logmar VA

19 Binocular SimVis Radhakrishan et al

20 Binocular corrections (monocal, multifocal, monovision, extended monovision) Average Monofocal Multifocal Monovision Modified mono Modified mono Far dominant Near dominant

21 SimVis simulation of real IOLs =? ü Bifocal refractive lens ü Trifocal diffractive lens Real lenses ü Aspheric lens 21

22 SimVis simulation of real IOLs Bifocal segmented refractive IOL IOL SimVis Akondi et al. VPO 2016

23 SimVis simulation of real IOLs Trifocal diffractive IOL IOL SimVis Akondi et al. VPO 2016

24 SimVis simulation of real IOLs Aspheric multifocal IOL Aspheric IOL SimVis Akondi et al. VPO 2016

25 Through-focus VA with real and simulated IOLs

26

27

28 Towards a rapid test in the clinic Day/Night street scenes 3-D steroacuity Day/Night reading scene

29 Conclusion ü Simultaneous Vision by temporal multiplexing allows Simulation of real multifocal designs ü Light, see-through, large field of view, binocular, affordable ü Effective way for the patient to experience multifocality and select correction prefernece

30

31 Visual Optics & Biophotonics Lab

32 Funding MINSTERIO DE CIENCIA E INNOVACION FIS ; FIS R i-link Program PIE VioBio icoop Program ERC-2011-AdG ERC PoC OCT4IOL ERC PoC SimVisSim Paris, France Liège, Belgium Monrovia, CA, USA Berlin, Germany Boston, MA, USA Santa Ana, CA,USA Singapore Marie Curie ITN Opal Marie Curie ITN MyFun COFUND Program