PANFOCAL Visual Acuity A Practical Measure of Functional

PAN-FOCAL Visual Acuity A Practical Measure of Functional Vision Milind Pande Andrew Bourne Emily Proudfoot Neha Vijh Vision Surgery & Research Centre East Yorkshire, United Kingdom Authors have no financial interest in the subject matter of this poster

Presbyopia IOL Mismatch • Patients: Can I – Drive – Use Desktop, Laptop, I phone – Read books, newspapers, magazines, telephone directories – Read in bed etc. . • We measure – Photopic Distance, Near, rarely Intermediate UCVA • Inadequate data to answer patient questions • Mismatch of patient expectations and Presbyopia IOL performance leads to unhappy patients despite good UCVA

Current Measures of Functional Vision in Presbyopia IOLs • VA across the full focal range: Photopic and Mesopic Defocus Curves • Photopic and Mesopic Contrast sensitivity at distance, inter and near • Time Hungry and Cumbersome • Totally Impractical in Clinical settings ®

PAN-FOCAL VA • Developed as a practical clinical measure of VA across distances and illumination levels. • Consists of Binocular Snellens UCVA for – Photopic (330 Lux) Distance – Photopic (330 Lux) Intermediate @ 65 cm – Photopic (330 Lux) and Mesopic (100 Lux) Near @ 33 cm

PANFOCAL VA: VALIDATION METHODS • 16 patients, > 6 weeks post-op • • Multifocal M&M 5 Bilateral same Multifocal 2 Accommodative 5 Monovision 4 • PANFOCAL VA measured • Patient Questionnaire • Objective Task Performance

OBJECTIVE ASSESSMENT INTERMEDIATE TASK PERFORMANCE DESKTOP & LAPTOP COMPUTING

OBJECTIVE ASSESSMENT NEAR TASK PERFORMANCE PHOTOPIC & MESOPIC Photopic: 330 Lux Mesopic: 100 Lux

PANFOCAL VA: Methods • Patients grouped by YES/NO responses to Questionnaire and Objective tasks performance. • VA thresholds analysed in YES/NO groups using Fishers Exact Test • This gave us VA thresholds for each objective task and subjective questionnaire <= 12 NS: 0. 87 <= 9 NS: 0. 02

PANFOCAL VA: RESULTS

PANFOCAL VA: RESULTS • A single measure of Functional VA derived from PANFOCAL VA: Mean PANFOCAL VA • Tested in groups with and without total spectacle freedom and objective task performance <=9 0. 03 <=9 0. 007

CONCLUSIONS • PANFOCAL VA <=6/9 is consistent with complete spectacle freedom • PANFOCAL VA <=6/9 is consistent with successfully performing tasks like computing on desktop, laptop; reading newspapers, novels, magazines and telephone directories in mesopic and photopic conditions • Mean PANFOCAL VA of <=6/9 is consistent with spectacle freedom as well as all objective task performance Good measure of Functional Vision • PANFOCAL VA is an excellent practical clinical measure of visual function

All Presbyopia IOLs should have PANFOCAL VA measurements to help match IOLs to individual patient needs PANFOCAL VA is a tool to get 20/HAPPY PATIENTS