CORTICAL STIMULATION USING GABOR PATCHES IMPROVES VISION AND CONTRAST SENSITIVITY IN DISSATISFIED PATIENTS WITH MF-IOLS: RESULTS OF RCT

To evaluate patient-specific, computer-based perceptual visual therapy (PL) regime using Gabor patches for improving vision & contrast sensitivity function(CSF) in patients not satisfied after multifocal IOL (MF-IOL) implantations

A prospective, controlled-randomized, open-label study.

Prospective, controlled-randomized, open-label study. Adults (50-80 yrs) with uneventful MF-IOL implantation, 4-24 weeks post-surgery, BCVA worse than 20/40 with sub-optimal CSF, complaining about vision quality were randomized in 2:1 ratio into treatment(G1), in which computer-based perceptual therapy using Gabor patches amidst co-linear flankers was employed and control(G2) arms. The study had 2 phases (screening + therapy periods(PL). Mid-training (Post 20 sessions), 40 training sessions, and post-therapy follow-up by 6 months were evaluated for improvements in BCVA distance & near (ETDRS) & CSF at spatial frequencies of 3, 6,12,18 CPD using Friedman tests for repeated measures.

30 cases were randomized into 2:1 ratio into treatment and control arms. 16 Trifocals(PanOptix), 14 Bifocals(Tecnis). The average improvement after treatment is 2.5 lines in LogMar in Treatment arm (p<0.0001), whereas no significant improvements among the controls. 83% Improvement in Contrast Sensitivity (CSF at 3,6,12 & 18 CPD) was observed in the Treatment Group(G1, p<0.0001) whereas no significant improvements amongst the controls using Friedman repeated measure tests.

Sequential, patient-specific, cortical stimulation improved vision & contrast (CSF) in dissatisfied MF-IOL patients with visual deficiencies & acts as proof of concept of improving neural connections at cortical levels. Phaco surgeons could consider it as a post-operative therapeutic adjuvant, in MF-IOL with visual deficiencies & reduced contrast.