RT info:eu-repo/semantics/article T1 Randomised placebo-controlled clinical trial evaluating the impact of a new visual rehabilitation program on neuroadaptation in patients implanted with trifocal intraocular lenses A1 Piñero, David P. A1 Maldonado López, Miguel José A1 Molina Martín, Ainhoa A1 García Sánchez, Noelia A1 Ramón, María L. A1 Rincón, José L. A1 Holgueras, Alfredo A1 Arenillas Lara, Juan Francisco A1 Planchuelo Gómez, Álvaro A1 Leal Vega, Luis A1 Coco Martín, María Begoña K1 Trifocal intraocular lens K1 Neuroadaptation K1 Cataract surgery K1 Contrast sensitivity K1 Visual training K1 Multifocal IOL AB PurposeTo evaluate the efficacy of a new visual training program for improving the visual function in patients implanted with trifocal intraocular lenses (IOLs).MethodsRandomised 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.ResultsNo 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.ConclusionsA 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. PB Springer Nature YR 2023 FD 2023 LK https://uvadoc.uva.es/handle/10324/70624 UL https://uvadoc.uva.es/handle/10324/70624 LA eng NO International Ophthalmology, 2023, vol. 43, p. 4035-4053 DS UVaDOC RD 24-nov-2024