GreenMan Vision Study Finds Virtual Reality May Improve Cataract IOL Education and Patient Satisfaction
GreenMan Vision, Inc. has announced the publication of a peer-reviewed, multi-center study evaluating InSightVR, a patient-specific virtual reality (VR) platform designed to help people undergoing cataract surgery visualize potential postoperative vision before selecting an intraocular lens (IOL). The retrospective analysis of 609 patients found that those who received education using InSightVR were more likely to select advanced-technology intraocular lenses (ATIOLs) and reported high levels of understanding, expectation alignment and satisfaction with the educational experience.
The study, titled “Patient Satisfaction with a Virtual Reality Education Tool for Advanced Technology Intraocular Lenses: A Retrospective Multi-Center Analysis,” was published in Patient Preference and Adherence. It examined cataract patients evaluated at five ophthalmology centers across the United States and compared outcomes among patients who received InSightVR-based education with those who received standard verbal counseling from healthcare providers.
Of the 609 patients included in the analysis, 289 received education using InSightVR, while 320 received standard education. The findings showed a substantial difference in ATIOL selection between the two groups. Among patients educated with InSightVR, 57.1% selected an advanced-technology IOL, compared with 28.4% of patients who received standard education. This represented 165 of 289 patients in the VR group compared with 91 of 320 patients in the standard-education group, with the difference reported as statistically significant at p<0.001.
The study also found that most patients who used InSightVR considered the experience helpful in understanding their lens options. Eighty-eight percent of respondents said the simulation improved their understanding of differences between IOL choices, while an additional 10% said it helped somewhat.
Virtual Reality Brings IOL Choices Into a Visual Experience
Cataract surgery requires patients to make important decisions about the type of IOL that will replace the eye’s natural lens. Different IOL technologies can provide different approaches to near, intermediate and distance vision, and patients may need to consider factors such as their lifestyle, visual priorities and tolerance for potential visual phenomena.
GreenMan Vision developed InSightVR to make these differences more tangible. Rather than relying exclusively on verbal descriptions, written materials or conventional diagrams, the platform uses patient-specific biometric information and immersive simulations to allow patients to experience potential differences among IOL options.
The platform can simulate several categories of lenses, including monofocal, toric, multifocal, extended-depth-of-focus and adjustable IOL options. It can also simulate monovision by independently controlling the visual experience presented to each eye.
Through the VR experience, patients can explore scenarios that resemble everyday activities. These may include reading and driving under both bright and dim lighting conditions. The simulations are designed to demonstrate potential differences in near, intermediate and distance vision, as well as visual effects such as glare and halos.
This personalized approach is intended to help patients connect technical differences between IOL technologies with the types of visual experiences they may encounter in everyday life.
Matt Larson, Chief Executive Officer of GreenMan, said cataract patients are frequently required to make long-term decisions about their vision using concepts that can be difficult to communicate through conventional educational materials alone.
According to Larson, the new peer-reviewed study provides evidence of an association between use of a software-based visual education platform and higher selection of advanced-technology IOLs. He also emphasized that the potential value of InSightVR extends beyond increasing ATIOL selection, pointing to its role in helping patients better understand visual differences before surgery.
High Levels of Patient Understanding
Patient feedback was a central component of the study. Among respondents who used InSightVR, 88% said the simulation improved their understanding of differences between available IOL options. Another 10% reported that the experience helped them to some degree.
The technology also received favorable usability feedback. A total of 83.6% of VR-group patients described the headset as easy or very easy to use.
These findings suggest that immersive technology can be incorporated into cataract education without necessarily creating a difficult experience for patients. The InSightVR session typically takes approximately five to 10 minutes and can be facilitated by a trained technician while patients are undergoing dilation.
The study authors reported anecdotal feedback indicating that patients who completed the VR experience often entered subsequent conversations with surgeons with clearer preferences and more specific questions. Although consultation time was not formally measured as part of the analysis, these observations suggest that visual education could potentially help make later discussions more focused.
For ophthalmology practices, this may offer a way to provide standardized information to patients before the surgeon consultation while allowing clinicians to concentrate on individualized recommendations and questions.
Postoperative Expectations and Satisfaction
The study also evaluated how well the simulated experience aligned with patients’ perceptions of their actual vision after cataract surgery.
At approximately three months following surgery, 90% of surveyed patients in the VR group who had selected ATIOLs reported that their real-world vision was similar to what they had experienced during the InSightVR simulation.
The finding is relevant because setting appropriate expectations before cataract surgery can be an important part of the patient experience. Visual outcomes can involve tradeoffs, and patients may have different priorities regarding distance, intermediate and near vision.
By allowing patients to experience simulated visual conditions before surgery, the InSightVR approach is designed to help them develop a more concrete understanding of potential outcomes.
Patient willingness to recommend the experience was also high. Ninety percent of surveyed patients in the VR group said they would recommend the VR educational experience to friends or family members undergoing cataract surgery.
Brandon Baartman, MD, Co-Founder of GreenMan, said the finding that approximately nine out of 10 surveyed patients reported postoperative vision resembling the simulation was particularly encouraging.
He noted that helping patients understand their options and establish expectations before surgery could contribute to both clinical outcomes and the broader patient experience.
Supporting Shared Decision-Making
The study authors emphasized that the purpose of InSightVR is not to encourage patients toward a particular IOL category. Instead, the technology is intended to support informed and preference-aligned decision-making.
This distinction is important because advanced-technology lenses are not necessarily the preferred choice for every patient. Individual visual goals and other factors can influence the most appropriate lens selection.
Some patients in the study who ultimately selected monofocal IOLs reported that the simulation helped them feel more confident that a monofocal lens was appropriate for their personal needs.
Michael Greenwood, MD, study co-author, cataract surgeon and Co-Founder of GreenMan, said the most significant finding was not simply the higher rate of advanced-technology lens selection. Rather, he highlighted the potential for patients to better understand the choices and tradeoffs involved in cataract surgery.
For ophthalmology practices, Greenwood said, a standardized visual experience may help the broader care team support patients while encouraging more active participation in shared decision-making.
Potential Workflow Advantages for Ophthalmology Practices
InSightVR may also have potential implications for clinical workflow. The platform generally requires approximately five to 10 minutes and can be administered by trained staff during the patient’s dilation period.
Because the VR experience can take place before the surgeon consultation, patients may have an opportunity to develop questions and preferences before discussing their options directly with the physician.
The study did not formally measure whether InSightVR reduced consultation time, so no conclusions can be drawn about efficiency based on the current analysis. However, the authors reported anecdotal observations from participating practices that patients sometimes entered surgeon discussions with a clearer understanding of their options.
If supported by future research, this type of workflow could allow clinical teams to devote more of the consultation to patient-specific considerations, surgical planning and discussion of individual goals.
Study Limitations
Despite the encouraging findings, the researchers emphasized several limitations that should be considered when interpreting the results.
The study was retrospective and non-randomized, meaning patients were not randomly assigned to receive either InSightVR or standard education. As a result, the findings demonstrate an association between use of the platform and the reported outcomes but cannot establish that InSightVR directly caused the observed differences in IOL selection or patient satisfaction.
The authors also identified potential selection bias, recall bias and non-response bias. There was variation among the participating centers, and postoperative survey information was available only for a subset of the overall study population.
These factors mean that the findings should be considered early evidence supporting further investigation rather than definitive proof of the platform’s effectiveness.
The authors recommended prospective randomized studies to evaluate the technology more rigorously. Future research could incorporate formal assessments of patient knowledge, objective measurements of consultation time and longer-term patient-reported outcomes.
Expanding the Role of Personalized Digital Education
The publication adds to the growing body of research exploring how digital and immersive technologies can be incorporated into patient education. In cataract surgery, where patients may have multiple IOL options and different expectations regarding postoperative vision, visual simulation could offer an alternative or complement to conventional counseling methods.
GreenMan’s findings suggest that giving patients an opportunity to experience simulated differences before surgery may help make complex visual concepts easier to understand. The high proportion of respondents reporting improved understanding and the reported alignment between simulated and postoperative experiences provide additional areas for future investigation.
The results also highlight the importance of individualized decision-making. Rather than positioning one lens category as appropriate for everyone, InSightVR is designed to show patients different potential visual experiences and allow those experiences to inform conversations with their care teams.
For patients considering cataract surgery, this approach could provide another tool for understanding what different IOL options may mean in everyday activities such as reading and driving.
GreenMan Vision will continue demonstrating InSightVR to ophthalmology professionals, including at the 2026 American Academy of Ophthalmology (AAO) meeting, where the company plans to exhibit at booth #4142.
The full peer-reviewed study, published in Patient Preference and Adherence, provides the detailed methodology and findings behind the analysis. Overall, the research indicates that patient-specific VR education is associated with higher selection of advanced-technology IOLs, strong reported understanding of lens differences and high satisfaction with the educational experience.
While prospective randomized research will be needed to determine whether these associations translate into measurable improvements in decision quality, clinical workflow or long-term patient-reported outcomes, the study provides evidence supporting further evaluation of immersive, personalized education in cataract care. By allowing patients to experience simulated visual differences rather than relying solely on verbal explanations, InSightVR represents a technology-based approach to helping patients participate more actively and confidently in decisions surrounding cataract surgery.
About GreenMan
GreenMan Vision, Inc. is an ophthalmic technology company dedicated to improving cataract patient education and shared decision-making. Its InSightVR platform uses immersive virtual reality and patient-specific biometry to simulate potential visual experiences with monofocal, toric, multifocal, extended-depth-of-focus and adjustable IOL options before surgery.
By independently controlling the simulation for each eye, InSightVR can also demonstrate monovision strategies based on different focal targets. By helping patients understand the benefits and tradeoffs of available approaches, InSightVR is designed to support more informed decisions, realistic expectations and productive cataract consultations.