2026-04-27T21:44:51Zhttps://uvadoc.uva.es/oai/request
oai:uvadoc.uva.es:10324/706242025-01-09T11:51:45Zcom_10324_1191com_10324_931com_10324_894col_10324_1379
UVaDOC author Piñero, David P. author Maldonado López, Miguel José author Molina Martín, Ainhoa author García Sánchez, Noelia author Ramón, María L. author Rincón, José L. author Holgueras López, Alfredo author Arenillas Lara, Juan Francisco author Planchuelo Gómez, Álvaro author Leal Vega, Luis author Coco Martín, María Begoña 2024-10-09T07:42:52Z 2024-10-09T07:42:52Z 2023 International Ophthalmology, 2023, vol. 43, p. 4035-4053 https://uvadoc.uva.es/handle/10324/70624 10.1007/s10792-023-02809-9 4035 11 4053 International Ophthalmology 43 1573-2630 Purpose To evaluate the efficacy of a new visual training program for improving the visual function in patients implanted with trifocal intraocular lenses (IOLs). Methods Randomised placebo-controlled clinical trial enrolling 60 subjects (age, 47–75 years) undergoing cataract surgery with implantation of trifocal diffractive IOL. Home-based active visual training was prescribed immediately after surgery to all of them (20 sessions, 30 min): 31 subjects using a serious game based on Gabor patches (study group) and 29 using a placebo software (placebo group). Visual acuity, contrast sensitivity (CS), and perception of visual disturbances (QoV questionnaire) were evaluated before and after training. Likewise, in a small subgroup, resting-state functional magnetic resonance imaging (rs-fMRI) analysis was performed. Results No significant differences were found between groups in compliance time (p = 0.70). After training, only significant improvements in monocular uncorrected intermediate visual acuity were found in the study group (p ≤ 0.01), although differences between groups did not reach statistical significance (p ≥ 0.11). Likewise, significantly better binocular far CS values were found in the study group for the spatial frequencies of 6 (p = 0.01) and 12 cpd (p = 0.03). More visual symptoms of the QoV questionnaire experienced a significant change in the level of bothersomeness in the study group. Rs-fMRI revealed the presence significant changes reflecting higher functional connectivity after the training with the serious game. Conclusions A 3-week visual training program based on the use of Gabor patches after bilateral implantation of trifocal diffractive IOLs may be beneficial for optimising the visual function, with neural changes associated suggesting an acceleration of neuroadaptation. eng Randomised placebo-controlled clinical trial evaluating the impact of a new visual rehabilitation program on neuroadaptation in patients implanted with trifocal intraocular lenses info:eu-repo/semantics/article 77u/QUNVRVJETyBERSAgRURJQ0nDk04gRUxFQ1RSw5NOSUNBIFkgRElGVVNJw5NOIEVOIElOVEVSTkVUIAoKRWwgb2JqZXRpdm8gZnVuZGFtZW50YWwgZGVsIFJlcG9zaXRvcmlvIEluc3RpdHVjaW9uYWwgIGVzICBsYSBkaXZ1bGdhY2nDs24gZGUgbGEgUFJPRFVDQ0nDk04gQ0lFTlTDjUZJQ0EgCmRlIGxhIFVuaXZlcnNpZGFkICBkZSBWYWxsYWRvbGlkLCBwYXJhIGxvIGN1YWwgbGEgVW5pdmVyc2lkYWQgcG9uZSBsb3MgbWVkaW9zIHTDqWNuaWNvcyBuZWNlc2FyaW9zIG9mcmVjaWVuZG8gIHVuYSAgCmJhc2UgIGRlICBkYXRvcyAgYSB0ZXh0byBjb21wbGV0byB5IGVuIGZvcm1hdG8gZWxlY3Ryw7NuaWNvLCBhIHRyYXbDqXMgZGUgSW50ZXJuZXQsIGZhY2lsaXRhbmRvIGFzw60gCmxhIHZpc2liaWxpZGFkIHkgYWNjZXNvIGEgbGEgaW5mb3JtYWNpw7NuIGNpZW50w61maWNhIHkgdMOpY25pY2EuCgpQYXJhICBxdWUgIGVsIFJlcG9zaXRvcmlvIGRlIGxhIFVuaXZlcnNpZGFkIGRlIFZhbGxhZG9saWQgcHVlZGEgcmVwcm9kdWNpciAgeSAgY29tdW5pY2FyIHDDumJsaWNhbWVudGUgc3UgCmRvY3VtZW50byBlcyBuZWNlc2FyaW8gbGEgYWNlcHRhY2nDs24gZGUgbG9zIHNpZ3VpZW50ZXMgdMOpcm1pbm9zLgoKQWNlcHRhbmRvIGVzdGUgQWN1ZXJkbywgdXN0ZWQgIE1BTklGSUVTVEE6CgpQUklNRVJPOiBTZXIgIEVsIGF1dG9yIGRlIGVzdGUgVHJhYmFqbyB5IHRpdHVsYXIgZGUgbG9zIGRlcmVjaG9zIGRlICBwcm9waWVkYWQgIGludGVsZWN0dWFsLiAgTWFuaWZlc3RhbmRvICBxdWUgc29icmUgCmxhIG1pc21hIG5vIHRpZW5lIGNvbnRyYcOtZG9zIG5pIGNvbnRyYWVyw6EgY29tcHJvbWlzb3MgbyBncmF2w6FtZW5lcyBkZSBuaW5ndW5hIGVzcGVjaWUgIHF1ZSBhdGVudGVuIApjb250cmEgbG9zIGRlcmVjaG9zIHF1ZSBhIGxhIFVuaXZlcnNpZGFkIGxlIGNvcnJlc3BvbmRhbi4KU0VHVU5ETzogUXVlIGVsIGRvY3VtZW50byBlcyB1biB0cmFiYWpvIG9yaWdpbmFsIHN1eW8geSBxdWUgdGllbmUgZGVyZWNobyAgcGFyYSAgb3RvcmdhciAgIGxvcyBkZXJlY2hvcyBjb250ZW5pZG9zIAplbiBlc3RlIGFjdWVyZG8uIApEZWNsYXJhICBxdWUgIHN1IGRvY3VtZW50byBubyBpbmZyaW5nZSwgZW4gdGFudG8gZW4gY3VhbnRvIGxlIHNlYSBwb3NpYmxlICBzYWJlciwgIGxvcyAgZGVyZWNob3MgZGUgYXV0b3IgZGUgbmluZ3VuYSAKb3RyYSBwZXJzb25hIG8gZW50aWRhZC4KVEVSQ0VSTzogU2kgZWwgZG9jdW1lbnRvIGNvbnRpZW5lIG1hdGVyaWFsZXMgZGUgbG9zIGN1YWxlcyBubyB0aWVuZSBsb3MgIGRlcmVjaG8gIGRlICBhdXRvciwgIGRlY2xhcmEgIHF1ZSAgaGEgIG9idGVuaWRvCmVsIHBlcm1pc28gc2luIHJlc3RyaWNjacOzbiBkZWwgcHJvcGlldGFyaW8gZGUgbG9zIGRlcmVjaG8gZGUgYXV0b3IgcGFyYSBvdG9yZ2FyIGEgbGEgIFVuaXZlcnNpZGFkICBkZSAgVmFsbGFkb2xpZCwgIApsb3MgIGRlcmVjaG8gIHJlcXVlcmlkb3MgcG9yIGVzdGUgQWN1ZXJkbyAgeSAgcXVlICBlc2UgbWF0ZXJpYWwgIGN1eW9zICBkZXJlY2hvcyBzb24gZGUgdGVyY2Vyb3MgZXN0w6EgY2xhcmFtZW50ZSAgCmlkZW50aWZpY2FkbyB5ICByZWNvbm9jaWRvICBlbiBlbCB0ZXh0byBvIGNvbnRlbmlkbyBkZWwgZG9jdW1lbnRvIGVudHJlZ2Fkby4KQ1VBUlRPOiBTaSBlbCBkb2N1bWVudG8gc2UgYmFzYSBlbiB1bmEgb2JyYSBxdWUgaGEgc2lkbyBwYXRyb2NpbmFkYQpvIGFwb3lhZGEgcG9yIHVuYSBhZ2VuY2lhIHUgb3JnYW5pemFjacOzbiBkaWZlcmVudGUgZGUgbGEgVW5pdmVyc2lkYWQgZGUgVmFsbGFkb2xpZCBzZSBwcmVzdXBvbmUgcXVlIHNlIGhhIGN1bXBsaWRvIApjb24gY3VhbHF1aWVyIGRlcmVjaG8gZGUgcmV2aXNpw7puIHUgb3RyYXMgb2JsaWdhY2lvbmVzIHJlcXVlcmlkYXMgcG9yIGVzdGUgQWN1ZXJkby4KUVVJTlRPOiBSZWNvbm9jZXIgcXVlIGFjZXB0YW5kbyBlc3RlIEFjdWVyZG8sIGVmZWN0w7phIHVuYSAgY2VzacOzbiAKbm8gZXhjbHVzaXZhIGRlIGVzdGUgVHJhYmFqbyBhIGxhIFVuaXZlcnNpZGFkIGRlIFZhbGxhZG9saWQsICBjb24gY2Fyw6FjdGVyICBncmF0dWl0byB5ICBjb24gZmluZXMgZXhjbHVzaXZhbWVudGUgZGUgCmludmVzdGlnYWNpw7NuIHkgZG9jZW5jaWEsICBhc8OtICBjb21vICBsYSAgY2VzacOzbiBubyBleGNsdXNpdmEgZGUgIGxvcyBkZXJlY2hvcyBkZSByZXByb2R1Y2Npw7NuLCAKY29tdW5pY2FjacOzbiAgeSAgZGlzdHJpYnVjacOzbiAgZGUgIHN1ICB0cmFiYWpvIG11bmRpYWxtZW50ZSwgZW4gZm9ybWF0byBlbGVjdHLDs25pY28gcGFyYSBzdSBkaWZ1c2nDs24gCnDDumJsaWNhLiAKTGEgdGl0dWxhcmlkYWQgZGUgbG9zIGRlcmVjaG9zIGRlIGV4cGxvdGFjacOzbiBkZSBsYSBwcm9waWVkYWQgaW50ZWxlY3R1YWwgc29icmUgbGEgb2JyYSBwZXJ0ZW5lY2UgeSBzZWd1aXLDoSAKcGVydGVuZWNpZW5kbyBhbCBBdXRvci4KCkxhIFVuaXZlcnNpZGFkIGRlIFZhbGxhZG9saWQsIGVuIHZpcnR1ZCBkZWwgcHJlc2VudGUgQWN1ZXJkbyAKREVDTEFSQSBRdWU6CgpQUklNRVJPOiBBbGJlcmdhcsOhIGVuIGVsIHJlcG9zaXRvcmlvIGluc3RpdHVjaW9uYWwgZGUgbGEgVW5pdmVyc2lkYWQgZGUgIFZhbGxhZG9saWQgIGVzdGUgVHJhYmFqby4gU2luIHBlcmp1aWNpbyBkZSBxdWUgCmVuIHVuIGZ1dHVybywgY29uIGVsIG9iamV0aXZvIGRlIGNvbnNlZ3VpciB1bmEgbWF5b3IgZGlmdXNpw7NuLCBzZWEgcmVjb2dpZG8gdGFtYmnDqW4gZW4gb3Ryb3MgcmVwb3NpdG9yaW9zIHF1ZSAKcHVlZGFuIGNvbnN0aXR1aXJzZSBhIG5pdmVsIHJlZ2lvbmFsLG5hY2lvbmFsIG8gaW50ZXJuYWNpb25hbC4gClNFR1VORE86IExhIFVuaXZlcnNpZGFkIGRlIFZhbGxhZG9saWQgcG9uZHLDoSBhIGRpc3Bvc2ljacOzbiBkZSBzdXMgdXN1YXJpb3MgbGEgIFBST0RVQ0NJw5NOIENJRU5Uw41GSUNBIApwYXJhIGVsIHVzbyBwcml2YWRvIHkgZmluZXMgZGUgaW52ZXN0aWdhY2nDs24gIHkgIGRvY2VuY2lhICBhdW5xdWUgIG5vIGdhcmFudGl6YSBuaSBhc3VtZSBuaW5ndW5hIHJlc3BvbnNhYmlsaWRhZCAgcG9yICAKbGFzICBmb3JtYXMgIGVuICBxdWUgIGxvcyAgdXN1YXJpb3MgIGhhZ2FuIHBvc3Rlcmlvcm1lbnRlIHVzbyBkZSBzdSBUcmFiYWpvLgpURVJDRVJPOiBMYSBVbml2ZXJzaWRhZCBubyB0aWVuZSBsYSBpbnRlbmNpw7NuIGRlIGNlbnN1cmFyIG5pIHJldmlzYXIgZWwgVHJhYmFqbyBkZWwgYXV0b3IgeSBlbiBjb25zZWN1ZW5jaWEgc2Vyw6EgCmVsIGF1dG9yICByZXNwb25zYWJsZSBkZWwgY29udGVuaWRvIGRlIHN1IG9icmEuCkNVQVJUTzogRW4gZWwgcmVwb3NpdG9yaW8gaW5zdGl0dWNpb25hbCBkZSBsYSBVbml2ZXJzaWRhZCBkZSBWYWxsYWRvbGlkICBzZSBoYXLDoSBtZW5jacOzbiBleHByZXNhIGEgbG9zIHVzb3MgCmF1dG9yaXphZG9zIGRlIGxhIG9icmEsIGJham8gbGEgbGljZW5jaWEgQ3JlYXRpdmUgQ29tbW9ucyBzZWxlY2Npb25hZGFzIHBvciBlbCBhdXRvciBkZWwgVHJhYmFqby4KCkVsIHByZXNlbnRlIEFjdWVyZG8gZW50cmFyw6EgZW4gdmlnb3IgZW4gZXN0ZSBtb21lbnRvIHkgdGVuZHLDoSB1bmEgZHVyYWNpw7NuIGluZGVmaW5pZGEuIFNpbiBwZXJqdWljaW8gZGUgCmVzdGEgZHVyYWNpw7NuIGluZGVmaW5pZGEgaW5pY2lhbG1lbnRlIHBhY3RhZGEsIHNlIHBvZHLDoSBwb25lciBmaW4gYWwgcHJlc2VudGUgQWN1ZXJkbzogcG9yIHZvbHVudGFkIGRlIGxhcyBwYXJ0ZXMsIApwb3IgaW5jdW1wbGltaWVudG8gZGUgY3VhbHF1aWVyYSBkZSBsYXMgb2JsaWdhY2lvbmVzIGRlcml2YWRhcyBkZWwgQWN1ZXJkbywgcG9yIHZvbHVudGFkIGV4cHJlc2EgZGVsIEF1dG9yCkVuICBwcnVlYmEgZGUgY29uZm9ybWlkYWQsIGxhcyBwYXJ0ZXMgYWNlcHRhbiBlbCBwcmVzZW50ZSBBY3VlcmRvCgoKCgo= URL https://uvadoc.uva.es/bitstream/10324/70624/1/s10792-023-02809-9.pdf File MD5 a1bf3ebfb67a01aa6e866fd0b6e92ee9 978156 application/pdf s10792-023-02809-9.pdf