Eyeworld

62 | EYEWORLD | SPRING 2024 ATARACT C by Liz Hillman Editorial Co-Director About the physicians Arthur Cummings, MD Medical Director Wellington Eye Clinic Dublin, Ireland Daniel Durrie, MD Chairman, iOR Partners Overland Park, Kansas Andrew Kopstein, MD K2 Vision Seattle, Washington Scottsdale, Arizona O ne might think that the topic of oc- ular dominance is simple, set, well understood. But in actuality, there are some recent findings that might have an impact on the concept and its relevance to lens selection and target setting for monovision and blended vision. "There's more to it than we think," said Arthur Cummings, MD. "The message is: We're learning more about dominance, and there is some data now to prove there is more to learn," said Daniel Durrie, MD. However, he added, further re- search is needed to understand the implications of this new data. 'New breakthrough data' There are two new facts when it comes to the topic of ocular dominance, which physicians like Dr. Durrie and Dr. Cummings are beginning to call sensory dominance. 1) There is variance in the level of dominance among patient populations. 2) An individual might have a different pref- erence for dominance when you test them for distance vs. near. Dr. Durrie started studying ocular domi- nance with the SimVis Gekko (2EyesVision). Prior to using this device, which not only assigns an ocular dominance preference score but allows the wearer to experience different intraocular lenses and blended vision, Dr. Durrie said ocular dominance was often tested with a hole in a card or with a finger triangle test. A group of ophthalmologists in the U.S. decided to use the SimVis Gekko to test for sensory dominance more definitively in their patient populations, assessing what the brain really prefers as far as dominance. This study included 269 patients enrolled at five centers. "The way that it's done is by putting a 1.5 lens in front of the eye electronically and asking the patient if they prefer one or two. [The Sim- Vis Gekko] does it 10 times really quickly," Dr. Durrie said. A new understanding for ocular dominance SimVis Gekko The SimVis Gekko (2EyesVision) is, according to the company, a "visual simulator for testing presbyopic corrections." The device is worn by the patient, and it allows them to "experience the real world through binocular presbyopic premium corrections before intraocular lens implantation, contact lens fitting, or presbyopic laser refractive surgery." Dr. Durrie said he wore the SimVis Gekko himself before choosing his own IOL. "It was helpful for me in picking my own optics for the IOL. … You could look through it at near and distance, walk around. … Not a lot of [practices] are going to buy this device just to do a domi- nance test that we don't know what usefulness it has, but it comes along with the machine because it's built into it. If someone wanted to simulate the usefulness of IOLs, which is the purpose of the de- vice, they could do this dominance test also." SimVis Gekko is a visual simulator that allows the patient to see the real world through any presbyopic correction prior to IOL implantation. Source: 2EyesVision

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