MULTIDISCIPLINARY EVALUATION TECHNOLOGY “INDIVIDUAL STUDIO” SBM SISTEMI ™ MADE AT THE CENTRE OF HEALTH CARE SERVICES FOR TORINO:
(Doct.G. FANTON,Doct. M. FAGIANO,Dott. E. BIANO,Doct. G. PIANA, Doct.G. FASANI)

Introduction
The new frontier in the discipline of the realization of progressive lenses is currently represented by custom lenses, which designed, built and centered according to the anatomical and behavioral needs of the patient’s visual apparatus. Until a few years ago everything was relayed on ophthalmologist or optometrist prescriber as well as the precision optician fitter and retailer, today these results can be achieved with the use of Individual Study (SBM ™ Systems technology) the which, in addition to ensuring an absolute precision in the relief of patient’s physical parameters, it ensures a standardization of the results able to increase patient compliance in a statistically significant way to the port of progressive lenses even in complicated situations anisometropia.

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Work scope
Assess the compliance of homogeneous groups of patients anisometropi complicated to customized progressive lens and the degree of subjective and objective satisfaction of the quality of vision achieved with and without the use of the
“Individual Study” in association with the software technology “Glass Studio”.

Materials and Methods
n total, who have been prescribed multifocal lenses between November 2008 and February 2009. Of these, 240 patients had never used progressive lenses were selected 422 patients, 64 had already experienced this type of lens, but had abandoned because they were dissatisfied and 118 already habitual wearers of progressive lenses.

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All patients were selected using the following:

Criteria of Inclusion
• BCVA (best corrected visual acuity) not less than 7/10 in at least one eye
• Presbyopia of any grade
• Refractive defect of between -8.00 and 4.00 + -2.50 and +2.00 between sphere and cylinder (any axis).

Criteria of Esclusion
• BCVA less then 7/10 at least one eye
• Retinal diseases (macular degeneration, diabetic retinopathy, hypertensive retinopathy) or degenerative (chronic open angle glaucoma) with confirmation of damage of the central visual field and / or peripheral
• Opacity of dioptric media
• Previous eye operations with the exception of phacoemulsification with IOL implantation
• Strabismus of whatever order and gender (correctable with prismatic base)
• Neurological and / or cognitive deficits
A simple test was administered to the patients enrolled in this study, aged between 44 and 86 years (mean age 65 years) sighted and heterogeneous for age, sex, level of education, occupation, general and BCVA health, finding survey on satisfaction of their quality of vision as well as on the current correction in use. The same test has been proposed again after fifteen days in the port of the prescribed progressive lenses. (See Annex 1)
All patients at enrollment, performed the following specialist examinations:
• Thorough eye examination and fundus examination in mydriasis pharmacological
• Visit orthoptics
• Visit optometric
• Visual field examination
• Analysis of the eye field
As a result of the examinations carried the cohort of patients was divided, depending on the visual problem encountered, in the following homogeneous groups:
• GROUP A: patients ametropic balanced with no more than 2 diopters of difference in the two eyes (value calculated spherical equivalent)
• GROUP B: anisometropi patients with more than 2 diopters of difference between the two eyes (value calculated spherical equivalent)
• GROUP C: pseudophakic patients
• GROUP D: patients antimetropi
Each subgroup was again divided into two subgroups of equal abundance. The α subgroup was used as the study group and the β group as a control group. The division into two subgroups was carried out at random and randomized double-blind at the time of the first visit.
All patients involved in this study were prescribed a correction with progressive lenses and the realization of the glasses was carried out by the same optical editors and retailers.
All patients included in subgroups Aα, Bα, Cα, and Dα were also examined with the Individual Study and at the time of sale the glasses you used the Glass Studio software. Individual Study examined the following parameters:
• pupillar distance
• vertex distance
• pantoscopic angolo
• data centering and parameters of the mount
• reading distance / near work
• wrap angle
The software was used to bring the patient to choose the type of progressive lens to be used (organic lenses, minerals, aspherical …) and to display the glasses chosen before ordering closure.
All sensitive data of patients enrolled in this study were treated in full compliance with applicable laws regarding the protection of privacy.

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Results
The results of tests administered before and after study of the enrolled patients were divided into positive and negative (see following tables)

Table A: pre-treatment results

Individual studio certifications

Table B: post-treatment results

Individual studio certifications

Overall, 96% of patients enrolled in the subgroups α and 87.5% of patients in the β sub-groups have declared full satisfaction of the visual performance achieved with new prescription. This difference was statistically significant. This difference was more relevant in the most complex patient groups (pseudophakic (Group C) and antimetropi (Group D)).
Considering three main cohorts of patients satisfaction in the quality of vision achieved by patients who had abandoned progressive lenses since dissatisfied was double in subcategories α (86%) compared to those β (43%).
In this cohort it belonged all of antimetropi patients and approximately 2/3 of the patients strongly anisometropi.
Opticians who have collaborated in this study reported that they had found great satisfaction from clients who could choose custom progressive lenses using the SBM Systems software.
Conclusion
The use of Individual Study in prescribing personalized progressive lenses proved irreplaceable element in achieving a good visual comfort for the patient since the early days of the port.
Use of the software Glass Studio to assist the patient in choosing their own customized progressive glasses is the result of invaluable help to the professional optometrist in ensuring a full understanding by the buyer as well as the achievement of full customer satisfaction.

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