Real-Time Control of a Focus Tunable Lens for Presbyopia Correction Using Ciliary Muscle Biopotentials and Artificial Neural Networks.

Ageing results in the progressive loss of near vision, known as presbyopia, which impacts individuals and society. Existing corrective methods offer only partial compensation and do not restore dynamic focusing at varying distances. This work presents a closed-loop correction system for presbyopia, employing biopotential signals from the ciliary muscle and an artificial neural network to predict the eye's accommodative state in real time. Non-invasive contact lens electrodes collect biopotential data, which are preprocessed and classified using a multi-layer perceptron. The classifier output guides a control system that adjusts an external focus-tunable lens, enabling both accommodation and disaccommodation similar to a young eye. The system demonstrated an accuracy of 0.79, with F1-scores of 0.78 for prediction of accommodation and 0.77 for disaccommodation. Using the system in two presbyopic subjects, near visual acuity improved from 0.28 and 0.38 to 0.04 and -0.03 logMAR, while distance acuity remained stable. Despite challenges such as signal quality and individual variability, the findings demonstrate the feasibility of restoring near-natural accommodation in presbyopia using neuromuscular signals and adaptive lens control. Future research will focus on system validation, expanding the dataset, and pre-clinical testing in implantable devices.