Cataract surgery involves the removal of the clouded natural lens and its replacement with a perfectly transparent intraocular lens (IOL). The procedure is necessary because, over time, the clouding of the lens becomes progressively more pronounced, and the resulting visual deficits increasingly interfere with the normal performance of daily activities.
Before the surgery, a series of eye examinations are required to measure certain parameters of the eye. The goal is to determine the most appropriate surgical technique and choose the most suitable intraocular lens.
Today, various types of intraocular lenses exist: in addition to monofocal IOLs—which allow focus only for distance, only for near, or only for intermediate distances—there are also multifocal IOLs or extended depth of focus (EDOF) lenses. These are latest-generation lenses that provide a much wider range of focus, for example, for far and near, for far and intermediate distances, or for intermediate and near distances, thereby reducing the time glasses are needed.
The correct choice of IOLs allows the patient to only need to use prescription glasses in certain situations which, ideally, should be those that occur less frequently in their daily life.
Why Personalized IOL Selection Matter
Every person has a different lifestyle, and the choice of IOLs to be implanted must necessarily be personalized: a vehicle driver, a computer terminal operator, and a scholar of ancient texts will require different IOLs. The selection of IOLs must therefore be based on the patient’s visual habits, and the correctness of this choice is of fundamental importance for their visual comfort after the surgery.
Despite the availability of extremely advanced surgical techniques and highly performing lenses, there is still a possibility today that the patient may not be fully satisfied after cataract surgery. This usually depends on an incorrect choice of IOLs, which translates into the inconvenience of having to wear glasses most of the time, whereas a correct IOL choice results in extremely reduced glasses usage.
The choice of IOLs is made during the pre-surgical eye examination and is based on the patient’s visual habits as reported by the patient themselves to the ophthalmic surgeon. However, it’s not uncommon, even in complete good faith, for the patient to provide imprecise or untruthful information, leading to decisions that then negatively impact their level of visual satisfaction after cataract surgery.
The Role of Artificial Intelligence
Artificial intelligence proves extremely useful in this phase. The patient’s visual habits can indeed be objectively acquired and analyzed by artificial intelligence with the aid of a micro-device installed on a pair of glasses worn by the patient for a test period of at least 36 hours.
During this timeframe, the device acquires the focusing distance used by the patient in their daily life tens of thousands of times. The focusing data is stored and sent to an artificial intelligence system, which then analyzes it objectively, thus establishing the patient’s real visual habits and needs.
The use of artificial intelligence allows for the error-free determination of the most suitable type of intraocular lens to implant, overcoming the limitations that can arise from an incorrect evaluation by the patient or the surgeon during the planning and personalization of cataract surgery.
The choice of IOLs assisted by artificial intelligence is already an available option but is not yet widely diffused. However, we believe that in the coming years, it will represent an indispensable tool for the correct planning of cataract surgery, guaranteeing every patient an excellent result in terms of visual comfort, with maximum independence from glasses for their entire life journey.
Dr. Jung Hee Levialdi Ghiron
Head of Scientific Communication, Rome Vision Clinic
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