Eyeworld

44 | EYEWORLD | SUMMER 2026 R EFRACTIVE Dr. Greenwood said the InSight VR prod- uct is fully immersive, and this software will work with a variety of headsets. The simulation is meant to be as realistic as possible. "We've worked hard on having high-end imagery for patients so that they feel like they're really in the environment. We understand the power of a truly immersive patient experience in creating patient understanding. The ability to actually interact with the virtual environment is a critical component of this," he said. This technology allows patients to interact with different objects and scenes. For example, there is an apartment scene, with a cookbook that the patient can interact with by bringing it closer or farther away to see the difference between a multifocal and a toric IOL. There's also a scene where they're sitting in a car, with objects going by and cars driving by. Patients can see what the headlight or taillight glare will look like, what it's like to interact with a cell phone giving directions. "The other thing that we can do with the product that we're really proud of is demon- strate each eye independently," he said. "We can show people what monovision is. We can show one eye at distance and one eye up close with a click of a button. Then we can flip it. If patients have never tried it before, it's an easy way to show them what is their dominant eye and what they can tolerate or can't tolerate." The InSight VR can also simulate a multi- focal in one eye and extended depth of focus in the other eye, or an adjustable lens in one eye and a multifocal in the other eye. If someone wants a toric in both eyes but they want to take their glasses off to read, this can be simulated as well. "We use the patient's own biometry to give an estimation of their astigmatism," Dr. Green- wood said. "Then we take their biometry and their expected outcome [and] plug it into our software, so each patient is customized." Continuing to improve on the technology is key, Dr. Greenwood said. "We have some studies that we've presented where we have shown that 92% of patients think the image that was shown to them before cataract surgery is representative of the vision they have after surgery, regardless of the lens they picked," he said. In some peo- ple, the glare/halo after surgery is a bit worse than what it was in the headset, and in some patients, it's the opposite, where they say their vision now is better than what was seen in the headset. He added that 93% of patients said they would recommend using this product to friends and family. They're also looking to see how much education patients get from this technology, comparing patient understanding on the front end before using it to their understanding of options after using it. Dr. Greenwood thinks VR is "here to stay," and that the InSight VR technology is another tool in the toolkit. "The way we do it in our clinic, and what we advise other clinics to do, is treat it like another diagnostic where you do your biometry, you do your OCT, you do your virtual reality education," he said. An educated patient is more likely to choose a premium IOL; Dr. Greenwood said he's seen this in his practice, and it's supported by research. One study looked at patients who were having bilateral cataract surgery who were candidates for multifocal or premium IOLs. If they didn't experience simulation with a head- set, 25% would choose a premium IOL. If they did try the headset, 57% chose a premium IOL. In another study, participants wore the headset if they were candidates for multifocal IOLs (with no major pathology) and were going to have bilateral cataract surgery. In that pop- ulation, 53% of patients chose a premium IOL. Again, you get a very high number of patients choosing a premium IOL, Dr. Greenwood said, which is great for patients because they're get- ting what they want. It's also great financially for the practice, he said "It can really impact a practice if you can increase your premium IOL rate, going from 25% to 30%." Dr. Greenwood said in his clinic, the InSight VR is used every day. There are some patients for whom it might not be as helpful, such as those who have already had one eye done and have a general idea what to expect or those who have a light perception cataract. "About 80% of our patients are candidates for using this," he said. VirtuaLens John Branch, MD, also saw the need for VR technology during his work as a cataract refrac- tive surgeon where he observed the challenge of helping patients understand the technologies available to them. "Patients have to learn the continued from page 43 continued on page 46

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