A Picture is Worth a Thousand Words: Pairing a Vision Simulator with ZEISS VERACITY Surgery Planner

1 June 2024
Image of J. Morgan Micheletti, MD
About the expert J. Morgan Micheletti, MD, FACS Dr. Micheletti practices at Berkeley Eye Center in Houston, Texas.

As cataract surgeons, one of our primary roles is to guide and advise our patients on the available options for surgery. We provide them with comprehensive information about the advantages and drawbacks of different technologies, ensuring they are well informed. Ultimately, however, it is their decision to make. We do filter out options that are clearly unsuitable for a patient's anatomy or vision goals, which helps narrow the list of viable choices. Yet, simply explaining in conceptual terms how one IOL differs from another often falls flat.

When patients find it difficult to distinguish between IOL options, it might be because we chose only to tell them about possible vision outcomes instead of showing them. By utilizing a vision simulator in conjunction with VERACITY Surgery Planner, we can show patients what their vision may look like with corrected versus uncorrected astigmatism or the difference between continuous range of vision and extended depth of focus. For many patients, this transforms the list of IOL options from a malaise of indistinguishable selections to a palate of nuanced, customized opportunities.

Let's see how using ZEISS VERACITY Surgery Planner to demonstrate differences in IOL technology better educates patients about their postoperative experience by setting clearer expectations for postoperative outcomes, thereby better equipping patients with astigmatism to make a choice that's right for them.

Showing Patients Their Possible Future via a Vision Simulator

Irrespective of their unique circumstances, patients often present to the clinic with a preconceived notion that a monofocal IOL is right for them. This means that surgeons can educate patients about the various IOL options which could better align with the patient’s goals and expectations.

ZEISS VERACITY Surgery Planner synthesizes preoperative biometric data and the patient’s survey to help craft a surgical plan, providing a predicted final refraction linked to a recommended lens technology. Using the dropdown menus in ZEISS VERACITY's user-friendly interface, I show patients how I am customizing their calculations to their specific history and anatomy (e.g., presence and extent of astigmatism, history of LASIK, etc.). In just a few taps. ZEISS VERACITY Surgery Planner generates a predicted postoperative refraction.

I show each patient what their predicted final refraction would be with a lens that I think would be a good fit for them, and they can see how that value rises and falls with different lenses when, say, moving from a monofocal to a toric IOL. Patients do not need to understand how to read a refraction to understand big numbers getting closer to zero as you manage their astigmatism. ZEISS VERACITY Surgery Planner makes toggling between these options nearly instantaneous.

When I'm reviewing the surgical plan in ZEISS VERACITY Surgery Planner with the patient, I use the predicted final refraction data generated by the software in tandem with an online vision simulator with simplified astigmatism scaling to demonstrate the differences between the various IOL options, including potential dysphotopsias.

This approach elevates the clinical appointment from an information session to an experience. Rather than having to imagine the quality of their postoperative vision, patients can understand at an experiential level how their functional vision would differ after implantation of their preferred IOL. And in patients with astigmatism, as I can illustrate the value of toric technology in terms they understand intuitively.

Using ZEISS VERACITY Surgery Planner in this way allows my patients to choose an IOL that fits their needs by showing them possible postoperative vision rather than telling them about it in subjective (and possibly imprecise) terms.

More Precisely Setting Patient Expectations

Another benefit of using a vision simulation tool in combination with ZEISS VERACITY Surgery Planner is that I can more clearly set expectations about both the complexity of surgery and the possible range of vision outcomes in the postoperative period.

When customizing a surgical plan with a patient, I show them how surgical calculations change based on several factors. Typically, these are specifics regarding any history of refractive surgery and the presence of (and degree of) astigmatism. When the patient understands how these factors affect the complexity of surgical calculations, they better grasp why their circumstances are mitigating factors to ideal outcomes—and therefore are less likely to hold unrealistic expectations regarding postoperative vision.

A common concern amongst surgeons is that patients may experience postoperative dissatisfaction due to misaligned expectations, particularly regarding the choice of IOL for astigmatism. Using a vision simulator during consultations significantly reduces this risk. The experience of "seeing" postoperative vision possibilities is difficult to forget and often leads to patients choosing an IOL that maximizes visual function, lowering the likelihood of disappointment from the start.

A Picture is Worth a Thousand Words with ZEISS VERACITY Surgery Planner

If your surgical clinic wants to elevate the presurgical patient experience in service of crafting a more satisfying postoperative experience, unlock the potential of ZEISS VERACITY Surgery Planner by empowering your patients to make a more informed decision in combination with a vision simulator. You'll move from merely telling your patients about their possible postoperative experience to showing AND telling them different ways their vision might function, allowing them to make the choice that best fits their lifestyle and tastes.

The statements of the author reflect only his personal opinions and do not necessarily reflect the opinions of any institution with whom he is affiliated.
The author has a contractual or other financial relationship with Carl Zeiss Meditec, Inc. and has received financial support.

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