KAANAPALI, Hawaii — A computer-based visual
cortex training system may be able to improve visual results in premium IOL
patients, according to results of a pilot study reported here.
Hawaiian Eye 2011, Jeffrey D. Horn, MD, reported that of 62
eyes undergoing neural vision training (RevitalVision) over a 3-month period
after premium IOL implantation, distance vision improved 1.2 lines and near
vision improved 0.7 lines. Both improvements were statistically significant
(P < .05),="" dr.="" horn="" said.="">
Contrast sensitivity improved 172% for distance vision and 101% for
near, he said.
At 1 month postop, uncorrected visual acuity and contrast sensitivity
measurements were taken for both near and far distances. The patients then
underwent visual cortical training sessions over a 2-month period, after which
visual acuity and contrast sensitivity were again measured.
"Pilot data are encouraging for improvement in visual acuity and
contrast sensitivity after IOL implantation," Dr. Horn said.
- Disclosure: Dr. Horn is a paid consultant for RevitalVision.
Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.
It is a well-confirmed fact that the brain retains plasticity and can
learn throughout life. My most poignant reminders of this fact are a small
handful of patients with amblyopia who, following loss of central vision in
their better eye, returned to 20/20 in the amblyopic eye over time. Neural
adaptation to a new visual system, for example following multifocal or
accommodating IOL implantation or monovision for that matter, is critical to
patient satisfaction. As I read the literature in this area, it appears that
around 80% of neural adaptation occurs in the first 3 months, and the remaining
20 % over 1 or more years. I have seen patient function improve for at least 3
years with both multifocal and accommodating IOLs.
Having performed multifocal implantation for over 20 years, I can state
that I have no patients that have not adapted to their new vision by 5 years
after surgery. Of course, 5 years is a long time with an unhappy patient, but
tincture of time is powerful in adaptation to a new visual system. I find it
helps to engage the patient in the recovery process, much like an orthopedic
surgeon does with physical therapy. I treat the ocular surface, any capsular
opacity and evaluate the macula with OCT and treat as indicated. I also
encourage use of the new optical system with reading in good light. More
recently I have adopted RevitalVision training for select patients.
My results are similar to Dr. Horns, with over a 100% improvement
in contrast sensitivity at distance and near and over a one line improvement in
Snellen acuity. For Crystalens patients, improvement at near is greater, and
for multifocal IOL patients, improvement at distance leads. In addition,
patients complain less of night vision symptoms after RevitalVision training.
The training sessions are done at home on ones own computer, and are
managed by the company. This vision training program is scientifically
validated and can enhance visual performance in many settings, including
presbyopia-correcting IOLs monofocal IOLs, Lasik, PRK, small refractive errors,
early presbyopia, amblyopia, early macular degeneration and sports medicine.
The interested physician can learn more on the RevitalVision website.
Richard L. Lindstrom, MD
Disclosure: Dr. Lindstrom is a consultant for RevitalVision
and has a financial interest in the company.