EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1545140
SUMMER 2026 | EYEWORLD | 47 R Relevant disclosures Branch: VirtuaLens Greenwood: GreenMan Marcos: 2EyesVision Rosenberg: Alcon Contact Branch: john@virtualens.health Greenwood: michael.greenwood@ vancethompsonvision.com Marcos: smarcos2@UR.Rochester.edu Rosenberg: ericr29@gmail.com and industrialize a practical solution. To ensure the device was compact, wearable, transparent, and offered a wide field of view, they devel- oped the SimVis technology based on temporal multiplexing. The platform simulates the optical performance of specific lens designs through the patient's own optical system, allowing the simulated correction to interact naturally with the optics of the eye. Dr. Marcos said that using this technolo- gy fits naturally in the preop counseling stage with minimum impact on chair time. "Using a simulator helps align expectations and en- courages shared decision-making," she said. "Patients understand better what each option means for them and can take a more active role in choosing their lens." In practice, she said, that supports more transparent preop coun- seling, stronger expectation management, and more confident patient decision-making without extending the visit. One of the values of this technology, Dr. Marcos said, is that patients directly experi- ence the differences among IOLs rather than merely hearing them described, fundamentally transforming the clinical conversation. This is especially valuable today, given the wide range of IOL options available. "Patients do not need to understand whether a lens is diffractive, mul- tifocal, or extended depth of focus," she said. They can simply "test drive" different options before implantation. "Notably, the technology can also simulate contact lenses, reducing chair time and min- imizing the trial and error process typically involved in contact lens fitting," Dr. Marcos said. "Because different lenses can be presented to each eye, the system also enables the simulation of bilateral combinations such as monovision, modified monovision, and mix-and-match con- figurations." This technology provides an exceptional level of realism, she said, which allows patients to move freely, read, and examine objects at varying distances and under different lighting conditions. Published comparisons of preoper- ative simulation and postoperative outcomes have shown close agreement in through-focus visual acuity and perceptual image quality for specific EDOF and trifocal lens designs, she said. Dr. Marcos noted that simulation technolo- gy is advancing rapidly, with substantial prog- ress made in this field. "The latest generation of SimVis Gekko2 features improved ergonomics, faster alignment through a Pupil Monitoring System, and a more intuitive user interface," she said. Future developments are expected to further enhance personalization and streamline integration into clinical workflows. "I also envision the evolution of see-through technologies that combine visual simulation— including prospectively more sophisticated optical designs—with wavefront sensing to eval- uate refractive errors and accommodative state. Such integration will be particularly relevant for myopia control strategies that rely on multifocal lens designs," Dr. Marcos said, adding that visu- al simulation is poised to become a standard of care in premium cataract and refractive surgery. The future of ophthalmology will be de- fined by patient-centered innovation, Dr. Marcos said. "Precision technology must not only improve surgical outcomes but also enhance patient understanding and confidence in clinical decisions. The SimVis Gekko2 embodies this approach by translating optical science into a tangible visual experience, enabling surgeons and patients to align their expectations and evaluate visual outcomes before surgery." The platform is backed by more than 25 scientific publications, including studies on simulation fidelity, performance in eyes with cataract, reproduction of halos and other photic phenomena, and correspondence with validated visual quality questionnaires, she said. With the SimVis Gekko2, the clinician operates a tablet application connected to the headset via Bluetooth, selecting the lenses to be tested. By looking at the real world through the optical simulation, patients are able to get a sense of how different lenses perform in day-to-day situations. Source: 2EyesVision