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Moderator
Scott E. LaBorwit, MD, ABO
Panelists
Richard Davidson, MD, ABO; Robin R. Vann, MD, ABO
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Michael D. Greenwood, MD
Co-Authors
Jack Wolsky (BSc)
Purpose
To evaluate visual outcomes, spectacle dependence, and patient satisfaction in glaucoma patients who received bilateral presbyopia-correcting intraocular lenses (multifocal, EDOF, or light-adjustable lenses) during cataract surgery with concurrent minimally invasive glaucoma surgery (MIGS).
Methods
This was a single-center, IRB-approved retrospective observational study with a cross-sectional telephone survey component. Patients underwent bilateral cataract extraction with implantation of the same type of presbyopia-correcting IOL (multifocal, EDOF, or LAL) between 2020 and 2025, combined with MIGS. A structured 11-question survey assessed satisfaction, spectacle use across six visual activities, and presence/bother of dysphotopsias. Clinical data from pre- and postoperative visits were extracted from charts. Patients with severe glaucoma or other vision-limiting comorbidities were excluded. A total of 79 patients completed both the chart review and survey.
Results
Descriptive and comparative analysis of spectacle dependence, satisfaction, and dysphotopsia frequency/severity across the three IOL groups will be presented. Preliminary findings suggest that most patients reported good visual outcomes and satisfaction, though rates of glare and haloes differed by IOL type. Spectacle independence trends and postoperative enhancement rates will also be analyzed.
Conclusion
Presbyopia-correcting IOLs, when carefully selected, may be a viable option for appropriately chosen glaucoma patients undergoing cataract surgery with MIGS. Final results will inform strategies for IOL selection and shared decision-making in this population.
Presenting Author
Masayuki Ouchi, MD, PhD
Purpose
To report three cases in which a multifocal posterior phakic intraocular lens (M-IPCL) was secondarily implanted in pseudophakic eyes previously implanted with monofocal intraocular lenses (IOLs).
Methods
This retrospective case series included three women aged 52, 53, and 64 years with prior monofocal IOLs. Case 1 had residual refractive error of −1.75 D and prior YAG capsulotomy. Case 2 had keratoconus, used hard contact lenses, and underwent bilateral toric IOL implantation. Case 3 had a history of epiretinal membrane surgery, monofocal IOL, and YAG capsulotomy. A multifocal IPCL was secondarily implanted in the pseudophakic eye of each case. Outcome measures included uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), and contrast sensitivity.
Results
Postoperative UDVA/UNVA in the M-IPCL–implanted eyes were −0.1 logMAR/J2, 0.1/J3, and 0.1/J3 for Cases 1–3, respectively. Contrast sensitivity exceeded the 50s average in Cases 1 and 2 and was slightly below the 60s average in high-frequency range in Case 3. None of the patients required near glasses or reported dysphotopsia.
Conclusion
Secondary M-IPCL implantation may be a useful surgical option for correcting both residual ametropia and presbyopia in pseudophakic eyes, with the added advantage of being removable if monofocal vision is later desired.
Presenting Author
Ali Nowrouzi, MD, FEBO, FACS
Purpose
To assess refractive outcomes of a trifocal intraocular lens (IOL) in post-myopic laser refractive surgery eyes.
Methods
This was a retrospective chart review of 30 eyes (15 patients), with history of laser refractive surgery, who were implanted with a trifocal IOL. Surgeon’s standard procedure included femtosecond laser (FLACS). The primary outcome measure was absolute prediction error. Secondary measures were refractive outcomes, postoperative residual astigmatism (PRA), monocular uncorrected visual acuity at distance (UDVA; 4m), intermediate (UIVA; 60cm), and near (UNVA; 40cm), and monocular best-corrected visual acuity at distance (BCVA; 4m).
Results
At 3 months postoperatively, 71% and 68% of eyes had an absolute prediction error 0.5 D. The percentage of eyes 20/20 or better for monocular UCVA, BCVA, UIVA, and UNVA was 93%, 100%, 86%, and 100%, respectively.
Conclusion
Implantation with a trifocal IOL can provide acceptable refractive and visual outcomes post-refractive surgery.
Presenting Author
David Tremblay, MD
Co-Authors
Phillip Brunson (OD)
Purpose
To evaluate the 3-month postoperative outcomes after bilateral implantation of the TECNIS Odyssey intraocular lens (IOL) in Patients undergoing a refractive lens exchange (RLE).
Methods
This study was a single center, ambispective study of visual outcomes after successful bilateral RLE surgery and TECNIS Odyssey implantation. A total of 80 eyes of 40 subjects at one site were targeted. Subjects were assessed at least 3 months postoperatively at a single visit. Clinical evaluations included measurement of photopic and mesopic visual acuities at distance, intermediate, and near, and administration of the assessment of intraocular lens implant symptoms (AIOLIS) questionnaire.
Results
A total of 40 patients completed the study. Binocular mean uncorrected visual acuities at 6m, 66cm, 40cm, and 33cm were -0.10 ± 0.06, 0.13 ± 0.08, 0.13 ± 0.11, and 0.09 ± 0.13 logMAR, respectively. The most commonly reported dysphotopsias were glare at night, halos, and floaters, with 25%, 22%, and 15% of subjects experiencing them "Always", respectively. However, only 8%, 5%, and 5% of subjects were "Extremely" bothered by glare at night, halos, and rings, respectively. In addition, 87% of subjects reported needing glasses "Not at all" or "A little of the time", and 88% of subjects rated their overall vision as "Excellent" or "Very good."
Conclusion
The results of this study suggest excellent visual outcomes at distance, intermediate, and near, minimal bothersomeness of dysphotopsias, and high spectacle independence with bilateral RLE surgery and Odyssey implantation.
Presenting Author
Robert L. Block, MD
Purpose
To retrospectively review the charts of at least 50 eyes implanted with the ClearView 3® Multifocal Intraocular Lens (Lenstec, Inc) at a 4-6 week endpoint. A comparison will be made between the pre-operative PCX and PCY (angle kappa) values and the final IOL position based on surgical observation of the 1st Purkinje reflex.
Methods
This retrospective chart review of at least 50 eyes implanted with the ClearView 3 Multifocal Intraocular Lens. Eyes with more than 1.50 D of astigmatism were excluded. Monocular UCDVA and UCNVA along with visual disturbances/dysphotopsia complaints were measured 4-6 weeks postoperatively. The parameters listed will be used to compare the pre-operative PCX and PCY (angle kappa) values to the final IOL position based on surgical observation of the 1st Purkinje reflex.
Results
TBD
Conclusion
TBD
Presenting Author
Grzegorz Labuz, PhD, BEng
Co-Authors
Ramin Khoramnia (MD), Gerd Auffarth (MD, PhD), Zhiyi Wu (MD)
Purpose
The RayOne Galaxy (Rayner Ltd.) is a recently introduced spiral intraocular lens (IOL) designed to correct presbyopia through a novel optical approach. The lens features a progressive change in power distributed in a spiral pattern. In this study, we evaluated the optical quality of the Galaxy and its potential to extend the range of vision.
Methods
The Galaxy lens was evaluated using an optical bench device under conditions designed to mimic the ocular environment. Polychromatic light, combined with a photopic eye-response filter, simulated the spectral sensitivity of the human eye. The eye model incorporated a corneal lens exhibiting a natural level of spherical aberration, as typically observed in the cataract population. Defocus curve predictions were generated using objective quality metrics validated in previous studies. Additionally, simulations of car headlight views were conducted to assess light distribution and identify potential sources of spurious light.
Results
The Galaxy lens demonstrated good simulated distance visual acuity, achieving -0.01 logMAR with a 3 mm pupil. The lens provided an extended range of vision, characterized by a smooth, elongated defocus curve without abrupt transitions, extending up to approximately 50 cm. Beyond this point, simulated visual acuity gradually declined, reaching 0.2 logMAR at around 40 cm. With a 4.5 mm pupil, distance vision remained good; however, the simulated defocus curve crossed the 0.2 logMAR threshold at approximately 70 cm. Apart from a slightly broader light distribution, the car headlight simulation did not reveal any noticeable halo rings.
Conclusion
The spiral lens demonstrates the potential to extend the visual range while carrying a low risk of photic phenomena. The lens provided uninterrupted vision up to approx. 50 cm, with visual acuity reaching 0.2 logMAR at reading distance. This limitation, along with the observed pupil dependency, should be considered during preoperative counseling.
Presenting Author
Christopher J. Engelman, MD
Co-Authors
Preethi Thiagarajan (OD, PhD), Ashvin Agarwal (MD)
Purpose
To assess the effect of pupil size and age on near visual acuity outcomes of the OmniVu lens system and evaluate the relationship between subjective accommodative amplitude (AA) and near vision following cataract surgery.
Methods
This prospective, single-center study included 25 eyes of 15 patients aged 42-77 years implanted with the OmniVu lens after cataract surgery. The system has a fluid-filled base lens that is designed to change shape with ciliary contraction and a fixed power front lens. At 12 months, photopic pupil size using distance fixation, monocular defocus curves at 4 m, AA, and distance-corrected near visual acuity (DCNVA) at 40 cm were measured. Correlations between pupil size, age, AA, and DCNVA were analyzed.
Results
Mean photopic pupil size was 3.6 ± 0.70 mm, AA was 2.41 ± 0.50 D, and DCNVA was 0.24 ± 0.1 logMAR. No significant correlations existed between pupil size and AA (r=0.165, p=0.42), pupil size and DCNVA (r=0.028, p=0.89), age and AA (r=-0.253, p=0.22), or AA and DCNVA (r=0.262, p=0.20).
Conclusion
OmniVu lens performance was independent of pupil size and age. The negative correlation between AA and DCNVA supports its mechanism of action. Future studies with a larger sample size are warranted to further evaluate these findings.
Presenting Author
Karl G. Stonecipher, MD
Purpose
To analyze the range of vision provided by an investigational modular shape-changing IOL and to characterize its functional vision performance across the entire range of vision from near to distance.
Methods
The prospective, multicenter, open-label first-in-human clinical trial analyzed 24-month data from 25 eyes with a cylinder no greater than 1.5 D implanted with a novel modular, shape-changing, fluid-filled IOL. Monocular and binocular defocus curves were used to evaluate lens performance. Visual acuity outcomes at distance (4 m), intermediate (66 cm), and near (40 cm) were analyzed to assess the range of vision provided by the dynamic lens mechanism.
Results
At 24 months, patients maintained 20/32 or better visual acuity over 3.5 D of continuous defocus monocularly, and over 4.7 D binocularly. The mean monocular uncorrected and distance-corrected distance, intermediate, and near visual acuities were 20/20, 20/20, and 20/25, respectively, and 20/16, 20/20, and 20/25, respectively. A sub-study of visual disturbances at 6 months showed most patients did not experience glare (92.8%), halos (92.8%), starburst (85.7%), and double images (100%). The modular, shape-changing IOL provided a dynamic range of vision while avoiding the common visual side effects associated with other presbyopia-correcting IOL designs.
Conclusion
The novel modular, shape-changing, fluid-filled IOL demonstrated a broad and continuous range of functional vision, supporting its potential to address presbyopia following cataract surgery.
Presenting Author
Josefina Botta, MD, MSc, MBA
Purpose
To evaluate the efficacy of a new spiral optic full range of focus IOL for cataract and presbyopia correction.
Methods
36 eyes of eighteen patients were included. A thorough ophthalmic examination was carried out in each patient, including ARM, UDVA, slit lamp and fundus examination, optical biometry, pupillometry, topography (Topcon Aladdin), spec. microscopy (Topcon SP-1P) and OCT (Topcon Maestro 2). Distance , intermediate and near vision were evaluated at 300, 60 and 40 cm respectively (Precision Vision Chart) . IOL calculations were obtained with the Raytrace web platform and Rayone Galaxy and Galaxy toric intraocular lenses were implanted. MU CHORD and pupil size were assessed postoperatively to be correlated with UDVA. Photic phenomena were inquired actively.
Results
Postoperative spherical equivalent vas -0,59 diopters SD +- 0.53. Postoperative uncorrected distance visual acuity was 0.0 LogMar in 66,7% of eyes, 0.1 LogMar in 25% of eyes and 0.2 LogMar in 8.3% of eyes. Patients achieved Intermediate and Near uncorrected visual acuity 0.0 LogMar in 100% of eyes. There were no correlation between visual acuity performance in relation to pupil diameter or decentration. No Photic Phenomena were cited by patients.
Conclusion
Rayone Galaxy IOL , designed with a unique non diffractive spiral optic provides excellent visual outcomes (full range DOF) , minimal photic phenomena and apparent pupil independence in relation to IOL centration. A higher N of cases should be evaluated for further confirmation of these findings.
Presenting Author
William F. Wiley, MD
Co-Authors
Mikheil Kurtanidze (MD), Ashvin Agarwal (MD)
Purpose
To evaluate the long-term visual outcomes, refractive stability, and durability of the shape-changing mechanism of a modular presbyopia-correcting IOL following cataract surgery.
Methods
This prospective, multicenter, open-label study included 10 patients (14 eyes) aged 60-87 who underwent phacoemulsification with implantation of the OmniVu modular shape-changing IOL. Patients were followed for 36 months. Outcome measures included monocular and binocular uncorrected and corrected visual acuity at distance (4 m), intermediate (66 cm), and near (40 cm), as well as manifest refraction spherical equivalent (MRSE).
Results
From 6 to 36 months, mean MRSE remained within ±0.50 D, while mean refractive cylinder remained between -0.50 D and -1.00 D. At 36 months, mean monocular uncorrected distance, intermediate, and near visual acuities were 20/20, 20/20, and 20/27, respectively. Mean binocular uncorrected visual acuities were 20/17 for distance, 20/18 for intermediate, and 20/26 for near. With correction, mean binocular visual acuities were 20/14 for distance, 20/15 for intermediate, and 20/20 for near.
Conclusion
Over 36 months, the modular shape-changing IOL maintained stable refraction, providing excellent distance and intermediate vision, and sustained improvement in near vision. These results support the durability of its mechanism and its potential to mitigate presbyopia over the long term after cataract surgery.
Presenting Author
Camille Bosc, MD
Co-Authors
Jean-Michel Bosc (MD), Romain Joubert (MD), Pierre Yves Santiago (MD)
Purpose
To analyse the clinical outcomes of a hydrophobic trifocal diffractive intraocular lens (IOLs) implanted in eyes with different axial lengths
Methods
This prospective study enrolled 116 eyes implanted with the FineVision HP IOL (Beaver-Visitec International, Inc., USA). The eyes were allocated into 3 groups according to their preoperative axial length: Group A (21.00-22.50 mm,n=17), Group B (>22.50-24.00 mm,n=83), and Group C (>24.00-28.50 mm,n=16).Post-operative outcomes at 3 months considered manifest refraction, monocular LogMAR uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA, at 40 cm)
Results
For Group A, 70.59% and 100% of eyes were within ±0.50D and ±1.00D, respectively; for Group B, these figures were 84.34% and 100%, respectively;for Group C, all eyes were within ±0.50D.The mean CDVA was above O Logmar for all groups. For distance vision, in Group A, 76.47% and 100% of eyes had a cumulative CDVA of �20/20 and �20/25, respectively. These percentages were 92.77% and 100% for Group B, and 93.75% and 100% for Group C, respectively. For near vision, for Group A, 11.76% and 100% of eyes had a cumulative DCNVA of �20/20 and �20/25, respectively. These percentages changed to 18.07% and 100% for Group B,and 12.50% and 100% for Group C, respectively.
Conclusion
The hydrophobic trifocal diffractive FineVision HP IOL provides good visual and refractive outcomes for eyes with different axial length
Presenting Author
Ramin Khoramnia, FEBO
Co-Authors
Tadas Naujokaitis (FEBO), Grzegorz Labuz (PhD, BEng), Hyeck Soo Son (MD), Gerd Auffarth (MD, PhD)
Purpose
To evaluate visual outcomes and patient-reported results with mini-monovision after the implantation of an extended depth of focus (EDoF) intraocular lens (IOL) in bilateral femtosecond-laser assisted refractive lens exchange (RLE).
Methods
An ongoing prospective interventional cohort study of patients implanted with the Vivity EDoF IOL (Alcon) during femtosecond laser assisted RLE in a university hospital setting. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance-corrected (DCIVA) intermediate visual acuity at 66cm, and uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity at 40cm were evaluated at three months postoperatively and compared with the preoperative values. In addition, we assessed the postoperative defocus curve and patient-reported spectacle independence.
Results
To date, 22 patients underwent the surgery. At 3 months after the surgery (n=7), the mean postoperative binocular UDVA was -0.06±0.05 logMAR and CDVA was -0.13±0.07 logMAR. The UIVA was -0.01±0.04 logMAR and DCIVA was -0.03±0.05 logMAR. The UNVA was 0.11±0.12 logMAR and DCNVA was 0.27±0.12 logMAR. In comparison to the preoperative binocular CDVA (-0.16±0.04 logMAR), no statistically significant change was observed (p>0.05), while all the other binocular visual acuities improved (p<0.05). In the mean binocular defocus curve, the visual acuity was better than 0.10 logMAR in the range between +0.5 D and -2.0 D. For most everyday tasks, patients reported complete spectacle independence.
Conclusion
The RLE surgery improved uncorrected visual acuity at far, intermediate and near distances without negatively affecting the CDVA. Patients achieved a high level of spectacle independence.
Presenting Author
Frederick Kremser, MD
Co-Authors
Oliver Hassel (MD), Lizaveta Chychko (MD), Lusine Vogormian (MD), Alexandra Teodora Negoescu (MD), Grzegorz Labuz (PhD, BEng), Hyeck Soo Son (MD), Ramin Khoramnia (FEBO), Gerd Auffarth (MD, PhD), Tadas Naujokaitis (FEBO)
Purpose
To evaluate the efficacy and safety of the Vivinex Gemetric and Vivinex Gemetric Plus IOLs (Hoya Surgical Optics) using the pairing approach in refractive lens exchange patients. The trifocal IOLs, distinguished by their different light distribution characteristics, are based on the hydrophobic Vivinex platform.
Methods
In this study, 56 eyes of 28 patients will undergo bilateral refractive lens exchange with the implantation of Vivinex Gemetric/Gemetric Plus IOLs using the pairing approach. The postoperative follow-ups at 3 and 6 months include assessments of uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance corrected (DCIVA) visual acuity at 66 cm, as well as uncorrected (UNVA) and distance corrected (DCNVA) near visual acuity at 40 and 33 cm. Defocus curve testing with distance correction is conducted as part of the 3-month follow-up visit.
Results
To date, 38 eyes of 19 patients were implanted with the Vivinex Gemetric and Vivinex Gemetric Plus IOLs. At 3 months, the mean binocular UDVA and CDVA were -0,01 logMAR and -0,03 logMAR, UIVA and DCIVA were 0,06 logMAR and 0,06 logMAR, UNVA and DCNVA at 40 cm were 0,03 logMAR and 0,03 logMAR. At 33 cm they were 0,01 logMAR bzw. -0,01 logMAR. After 6 months UDVA and CDVA were -0,01 logMAR and -0,09 logMAR, UIVA and DCIVA were 0,02 logMAR and -0,01 logMAR, UNVA and DCNVA at 40 cm were -0,02 logMAR and -0,05 logMAR and at 33 cm they were -0,01 logMAR and -0,03 logMAR. The binocular distance-corrected defocus curve showed visual acuity of 0.10 logMAR or better between +0.5 D and -3.5 D.
Conclusion
The paired implantation of the two different trifocal IOLs resulted in a good binocular visual acuity at all tested distances and a wide range of defocus.
Presenting Author
Lional Raj Daniel Raj Ponniah, MD, PhD
Purpose
Photic phenomena, neuro-adaptation failures are major concerns after MFIOLs. This study evaluated patient-specific, perceptual visual therapy(VPL) regime using Gabor patches (grey level gratings, specific for receptive visual fields) for improving vision & contrast sensitivity function(CSF) in patients not satisfied after MF-IOL implantations.
Methods
A Prospective, controlled-randomized study. Adults (50-70 yrs) with uneventful MF IOLs, over 24 weeks post-surgery, BCVA worse than 20/40 with sub-optimal Contrast(CSF), complaining about vision quality, were randomized in a 2:1 ratio into Treatment(G1), in which computer-based perceptual therapy using Gabor patches amidst co-linear flankers was employed & Control(G2) arms. The study had 2 phases (screening + therapy). Mid-training (Post 20 sessions), 40 training sessions, post therapy follow-up by 6 months were evaluated for improvements in BCVA distance & near (ETDRS) & CSF at spatial frequencies of 3, 6,12,18 CPD with FACT sine wave grating, using Friedman tests for repeated measures.
Results
30 cases were randomized into a 2:1 ratio into treatment and control arms. Subgroup consisted of 16 Trifocals (PanOptix), 14 Bifocals (Tecnis). The average improvement after VPL therapy is 2.5 lines in Log Mar in the Treatment arm (p<0.0001), whereas no significant improvements were observed among the controls. Tests for repeated measures showed 83% improvement in Contrast Sensitivity (CSF at spatial freq. of 3,6,12 & 18 CPD) in the Treatment Group(G1, all p<0.0001), whereas no significant improvements were observed amongst the controls.
Conclusion
Sequential, post-operative, patient-specific, cortical stimulation improved vision & CSF in patients with dissatisfied Multi Focal-IOL subjects & acts as proof of concept of improving neural connections at cortical levels. The key to optimizing vision following MF-IOLs lies in training the brain to improve neuroadaptation processes.
Presenting Author
Imene Salah, MSc, PhD
Co-Authors
Damien Gatinel (PhD, MD)
Purpose
To evaluate long-term visual, refractive, and patient-reported outcomes five years after implantation of the FineVision® trifocal intraocular lens (IOL), the first trifocal IOL introduced to clinical practice.
Methods
Patients undergoing cataract surgery with FineVision® implantation were prospectively enrolled between 2019 and 2025. Standardized postoperative examinations were performed at 6 months, 1 year, and annually up to 5 years. Assessments including uncorrected and corrected distance visual acuity (UDVA, CDVA), intermediate (UIVA) and near visual acuity (UNVA), refractive stability, defocus curve, spectacle independence, and quality-of-life outcomes assessed using validated patient-reported questionnaires have been reported. Safety was evaluated by recording adverse events and secondary surgical interventions.
Results
A total of 49 eyes from 25 patients completed five-year follow-up. Refractive stability was excellent, with >90% of eyes within 0.08 D ± 0.58D of target at five years. Mean binocular UDVA reached -0.1, UIVA 0.1, and UNVA 0.3 LogMar or better in over 80% of patients. The defocus curve showed sustained functional vision across far, intermediate, and near ranges. Spectacle independence remained high at 92%, and >90% of patients reported being "very satisfied" or "completely satisfied" with their vision. 60% of patients described low severity, frequency and bothersomeness halos, with no increase over time and minimal impact on daily functioning. No sight-threatening complications were observed.
Conclusion
5 years after implantation, the FineVision® trifocal IOL delivers excellent refractive accuracy, stable visual acuity across all distances, high levels of spectacle independence and durable patient satisfaction with a favorable safety profile. These findings confirm the long-term efficacy and safety of the first commercially available trifocal IOL.
