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Moderator
Lisa McIntire, MD, ABO
Panelists
Helga P. Sandoval, MD, MSc; Vance M. Thompson, MD
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
Lukas Mees, MD
Co-Authors
Luke Rebenitsch (MD)
Purpose
Mix and match strategies with an extended depth of focus (EDOF) IOL and a full vision range (FVR) IOL have shown improved range of vision and reduction in photic phenomena. This study compares a mix and match approach with a new FVR (DRN00V) and an established EDOF (DXR00V) with bilateral DRN00V and DFR00V/DXR00V mix and match approaches.
Methods
A retrospective chart review was performed at a single center. A total of 300 consecutive eyes from 150 patients were divided into group RX (DRN00V/DXR00V), RR (bilateral DRN00V) and FX (DFR00V/DXR00V) based on what IOL was implanted. Uncorrected distance and near vision was compared at 3 and 6 months. Refractive outcomes were analyzed based on differences in final manifest refraction compared to preoperative planning. The incidence of refractive enhancement and the spherical equivalent of the treatment at 6 months was compared. Patient satisfaction, incidence of dysphotopsias and spectacle independence was analyzed based on survey responses.
Results
No adverse events were reported. There was no significant difference found in UDVA between the three groups at three months or at final measurement (p=0.56, 0.37 respectively). Near vision was statistically better in the FX and RR group compared to the RX group both at three months and at final measurement (p<0.001 for both time points). There was no significant difference in spherical equivalent or cylinder outcomes, however the RX group underwent a higher rate of enhancement (p=0.014). Patients were highly satisfied (4.3/5 overall), with no significant difference found in satisfaction, dysphotopsias, spectacle use or rated vision quality at any distance.
Conclusion
UDVA, patient satisfaction, and spectacle independence was found to be excellent for all three groups. UNVA was decreased and enhancement rate was higher in the RX group. This study did not show an improvement in patient reported intermediate distance in the RX group as hypothesized.
Presenting Author
Grzegorz Labuz, PhD, BEng
Co-Authors
Agnieszka Zielinska (PhD), Gerd Auffarth (MD, PhD)
Purpose
Presbyopia-correcting IOLs often cause glare due to multiple focal points, and diffractive designs may further increase photic phenomena. This study evaluates glare effects from the diffractive profiles of two trifocal IOLs using a clinical straylight meter.
Methods
Straylight measurements provide an objective means to quantify the potential of an IOL to induce glare. In this study, straylight was assessed with a C-Quant straylight meter (Oculus GmbH) at 7°, with modifications allowing evaluation at lower angles (2.5° and 3.5°). The IOLs tested were the Clareon PanOptix (Alcon Vision, LLC) and the Tecnis Odyssey (Johnson & Johnson Vision). Measurements were obtained through the IOLs using additional optical components mounted on the device. Straylight is expressed in deg�sr?�, with values near zero indicating minimal scattering and, consequently, negligible glare from the diffractive design.
Results
At a 7° angle, the Clareon PanOptix demonstrated a low straylight value, averaging 0.3 ± 0.2, compared to 2.2 ± 0.7 for the Odyssey. For reference, a clear crystalline lens induces 2.5, and a 70-year-old lens 11.2 of straylight. At 3.5° (closer to the light source), straylight increased to 6.8 ± 0.8 with the Odyssey and 3.0 ± 1.1 with the Clareon PanOptix. The most pronounced increase was observed at 2.5°, near the light source, where the Odyssey reached 9.3 ± 0.5, while the Clareon PanOptix measured 4.6 ± 0.1, representing approximately a two-fold difference.
Conclusion
The Clareon PanOptix demonstrated lower straylight values across all tested angles compared with the Odyssey, suggesting a reduced potential for glare phenomena associated with its diffractive structure. Further research is needed to clarify how the increased straylight at lower angles correlates with patients' subjective visual disturbances.
Presenting Author
Hosik Hwang, MD, PhD
Co-Authors
Chul Young Choi (PhD, MD), JongIn You (MD, PhD), Seung Pil Bang (MD, PhD)
Purpose
To compare the optical function of Synergy and Odyssey intraocular lens by mobile model eye
Methods
The mobile model eye consists of an artificial cornea, an IOL, a wet cell, an adjustable lens tube, an objective lens, and a digital single-lens reflex camera. We collected photographs of distant buildings (day and night) and streets at night, and videos of United States Air Force resolution target from 6 m to 25 cm and analyzed them quantitatively. We compared the results of Synergy (Johnson&Johnson) and Odyssey(Johnson&Johnson)IOL.
Results
The letters on the signboard of distant buildings looked clearer in Odyssey than in Synergy. For Synergy, the contrast modulation was 0.104 at 6 m. It then decreased and increased again. At 47 cm, it was 0.058 and then decreased again. For Odyssey, the contrast modulation was 0.156 at 6 m. It then decreased and increased again. At 47 cm, it was 0.064 and then decreased again. Halo around light at night was comparable in Synergy and Odyssey.
Conclusion
Contrast modulation of Odyssey is higher than that of Synergy at far distance. Halos around light at night were comparable in Synergy and Odyssey.
Presenting Author
Clayton G. Blehm, MD
Purpose
To compare visual acuity outcomes in patients bilaterally implanted with trifocal (Clareon PanOptix) intraocular lens (IOL) or trifocal (enVista Envy) IOL.
Methods
An ambispective, multi-site study of patients bilaterally implanted with Clareon PanOptix IOL or enVista Envy IOL. A total of 20 subjects in each group were brought back for clinical evaluation between 2.5 and 5-months post-surgery. Clinical evaluations included binocular photopic high contrast uncorrected and distance-corrected (DC) VAs, binocular photopic low contrast (25%) DCVAs and binocular mesopic high contrast DCVAs at distance, intermediate (60 cm), and near (40 cm and 33 cm), binocular mesopic contrast sensitivity, and spectacle independence.
Results
Binocular photopic BCDVA, DCIVA, DCNVA 40 and 33 cm: (P) 0.00±0.05, 0.02±0.05, 0.12±0.12, and 0.16±0.08, respectively; (E) -0.01±0.08, 0.08±0.09, 0.13±0.09, and 0.24±0.12. Similar low contrast BCDVA and DCNVA were observed except the DCIVA and DCNVA (33 cm): (P) 0.24±0.07, 0.40±0.15 (E) 0.30±0.12, and 0.48±0.12. Under the mesopic condition, (P) provided about 4.5~ 8.5 letter better DCVA at intermediate and near. PanOptix provided similar mesopic CS with or with glare at 3,6 and 12 cpd. Spectacle independence in bright light for D, I, and N were: (P) 95%, 95%, and 95% respectively; (E) 95%, 95%, and 85% respectively. Dim light all percentages were the same, except (E) was 65% at near.
Conclusion
This ambispective study demonstrated good range of vision from distance to near for both PanOptix and Envy trifocal IOLs with PanOptix showing better intermediate and near distance corrected visual acuities, especially under mesopic condition.
Presenting Author
Andrew A. Kao, MD
Co-Authors
Daniel Chang (MD), Laura Huggins (OD), Brittany Camirand (BSc)
Purpose
Low-light dysphotopsias are a common complaint by presbyopia-correcting IOL patients. Patient-reported outcome (PRO) data only records subjective recall of visual symptoms. Clinical halometry can provide quantitative objective real-time photic phenomena data for various light colors and intensities. This study compares PRO and halometry outcomes.
Methods
This is a prospective, single-center clinical investigation of up to 120 pseudophakic patients implanted with Tecnis Eyhance Monofocal IOL (models DIB00 and DIUxxx), Tecnis Symfony Optiblue Extended Depth of Focus IOL (models ZXR00V and ZXWxxx) and the Tecnis Odyssey Full Visual Range IOL (models DRN00V and DRTxxx). Various colors (warm white, cool white, red, yellow, and green) will be tested at three light intensities to compare objective low-light photic phenomena measurements to the patient's subjective reports on validated PROs (AIOLIS and PRVSQ2).
Results
Mean duration postoperative was significantly longer for the Symfony compared to the Eyhance and Odyssey cohorts (39.2 vs 14.5 and 11.0 months). Significant differences in halo size from cool white, warm white, red, yellow, and green light were noted between Odyssey and Symfony (0.007cw, 0.005ww, 0.000r, 0.005y, 0.009g) as well as Odyssey and Eyhance (0.002cw, 0.008ww, 0.000r, 0.002y, 0.000g). Significant differences in starburst size in yellow and green light were noted between Symfony and Eyhance (0.002y, 0.009g). Similar trends in visual symptoms were noted on PRO testing.
Conclusion
Halos were reported more frequently with Odyssey compared to the Symfony Optiblue and Eyhance cohorts, while starbursts were more commonly observed in the Symfony and Eyhance groups. These findings may be influenced by differences in neuroadaptation time, as Symfony had a significantly longer adaptation period than Odyssey and Eyhance.
Presenting Author
Ishan M. Pandya, MD
Purpose
To compare the visual outcomes after cataract surgery in a mismatch approach with one eye trifocal and one eye EDOF lens versus the bilateral implantation of a trifocal lens . The study also compared the the effect of ocular dominance in mix match approach with distant dominant eye getting trifocal versus distant dominant eye getting EDOF lens.
Methods
It is a prospective, a single centre triple armed study. 30 patients were chosen with Group A of 10 patients with bilateral implantation of trifocal lens ( Rayner galaxy IOL). Group B was 10 patients with mix match approach with distant dominant eye receiving the advanced monofocal (Rayner EMV) and other eye receiving trifocal lens. Group C was 10 patients was also mix match approach , with the distant dominant eye receiving the trifocal. Follow up for visual acuity for distance , intermediate and near was done at 1 week, 1 month and 3 months. Spectacle independence and quality of vision questionare was assessed and contrast sensitivity was measured in Mesopic and Scotopic condition.
Results
TBD
Conclusion
TBD
Presenting Author
Roger Zaldivar, MD, MBA, MSc
Purpose
This study aims to evaluate comparative clinical outcomes of distance, intermediate and near visual acuities and patient reported outcome measures (PROMs) with a new refractive spiral IOL designed with artificial intelligence against a diffractive full (FROF) and a partial range of depth of field IOL (commonly referred to as EDOF IOL).
Methods
This single-centre, prospective, comparative study with a retrospective control includes 48 patients in the refractive spiral group, 48 patients in the Partial-ROF and 44 patients in the FROF group. The postoperative follow-up at one month and three months include subjective refraction, monocular visual acuities UDVA, CDVA, DCIVA, DCNVA and PROMs collected with the RevAI-RayPRO questionnaire. The refractive spiral and the FROF groups were targeted for emmetropia and in the Partial-ROF group the non-dominant eyes were targeted for slight myopia of -0.25 D to achieve a mini-monovision outcome. At the time of these abstract postoperative outcomes at 1 months are presented.
Results
The mean CDVA and UDVA in the refractive spiral, FROF and Partial-ROF groups were 0.08, 0.05, 0.02, 0.08, 0.02 and 0.18 logMAR, respectively. The mean DCIVA and DCNVA in the refractive spiral, FROF and Partial-ROF groups were 0.10, 0.12, 0.16, 0.15, 0.03 and 0.30 logMAR, respectively. The overall spectacle independence rate was 90%, 87% and 78% in the refractive spiral, FROF and Partial-ROF groups, respectively. Dysphotopsia was overall reported by 22%, 29% and 20% of patients in the refractive spiral, FROF and Partial-ROF groups, respectively. The overall patient satisfaction rates were 96%, 88% and 91% in the refractive spiral, FROF and Partial-ROF groups, respectively.
Conclusion
The Galaxy refractive spiral IOL achieves top spectacle independence, excellent visual acuity across all distances, and superior near vision compared to Partial-ROF IOLs, matching diffractive FROF IOL performance. Its dysphotopsia score equals Partial-ROF IOLs, with fewer nighttime driving disturbances than diffractive FROF IOLs.
Presenting Author
Curtis R. Martin, MD
Co-Authors
Fatma Shakarchi (MD, MSc), Nicolas Zaunbrecher (MD), Stephen LoBue (MD), Wyche Coleman (MD), Timothy Link (MD), Christopher Shelby (MD), Brittany DeNaro (DO), Ayorinde Cooley (MD, PhD)
Purpose
To compare visual performance and patient satisfaction of various intraocular lenses (IOLs) in patients who underwent bilateral cataract extraction with plano outcomes using the validated Refractive Cataract Surgery Survey (RCSS).
Methods
This is a retrospective comparative study. Patients underwent sequential bilateral cataract surgery with implantation of AcrySof PanOptix Trifocal, SA60, or TECNIS Eyhance IOLs. All surgeries were performed by a single surgeon using femtosecond laser-assisted cataract surgery. Patients were followed postoperatively at day one, one month, and three months, with RCSS evaluation at one month. Exclusion criteria included postoperative spherical equivalent > 0.5 diopters and/or cylinder > 0.75 diopters in either eye.
Results
253 eyes (126 patients): 75 eyes (29.6%) SA60, 126 eyes (49.8%) PanOptix, 52 eyes (20.6%) Eyhance. SA60 achieved best BUDVA (-0.047 logMAR), PanOptix (-0.027 logMAR), Eyhance (-0.022 logMAR). PanOptix showed superior BNVA (-0.02 logMAR) vs all IOLs (P<0.001). SA60 scored highest distance vision (9.71±0.62); PanOptix highest intermediate (P<0.001) and near vision (8.83±1.62, P<0.001). PanOptix achieved greatest spectacle independence (9.60±1.26, P<0.001). Satisfaction: 95% PanOptix, 87% SA60, 77% Eyhance would choose same lens (P<0.01). Dysphotopsia: 68% PanOptix (?�=52.543, P<0.001), limiting activities 11.1%, reduced to 6% post-YAG.????????????????
Conclusion
By removing refractive error, this study enables accurate IOL performance assessment. The validated RCSS helps provide a comprehensive view of objective and subjective outcomes, reflected in patient satisfaction and functional vision. This method offers a reproducible framework for evaluating future presbyopia-correcting technologies.
Presenting Author
JongIn You, MD, PhD
Co-Authors
Hosik Hwang (MD, PhD), Seung Pil Bang (MD, PhD), Joon Young Hyon (MD)
Purpose
To quantitatively compare the astigmatism tolerance of three types of commercially available multifocal intraocular lenses (IOLs)—bifocal (Restor), extended depth-of-focus (Symfony), and trifocal (POD-F)—using a full-wave computational optics simulation based on a customized finite eye model.
Methods
We implemented a polychromatic full-wave optical simulation of the entire eye structure, incorporating diffractive multifocal IOLs. The customized eye model evaluated visual performance under varying levels of corneal astigmatism using energy-based metrics, including light-in-the-bucket analysis for each focal point. We also examined how specific optical features—such as the optical power of diffractive zones, high-order harmonic contributions, and chromatic aberration—affect astigmatic tolerance.
Results
Simulation results indicated that the EDOF IOL (Symfony) exhibited the highest tolerance to corneal astigmatism, followed by the bifocal (Restor) and trifocal (POD-F) IOLs. Based on energy efficiency metrics, the suggested astigmatism thresholds for considering multifocal toric IOLs were >+1.5 D for Symfony, >+1.0 D for Restor, and >+1.0 D for POD-F. The findings align well with previous clinical reports, supporting the validity of the computational approach.
Conclusion
This computational optics-based simulation provides a reliable and quantitative method to assess astigmatism tolerance in multifocal IOLs. The model enables individualized predictions of postoperative visual function and offers theoretical support for selecting toric multifocal IOLs based on a patient's corneal astigmatism profile
Presenting Author
Elif Demircan, MD
Co-Authors
Anuradha Ondhia (OD), Iqbal Ike Ahmed (MD, FRCSC), Wesam Shamseldin Shalaby (MD), Eknoor Padda (None)
Purpose
Purpose (219/350): To assess and compare visual and refractive outcomes after bilateral implantation of Clareon Vivity (hydroxyethyl methacrylate) and AcrySof Vivity (phenylethyl methacrylate) IOLs in patients undergoing cataract surgery.
Methods
This prospective, randomized, double-masked study included adults ?45 years with bilateral cataracts (grade 2-3) and monocular visual potential of 20/25 or better. Bilateral small incision phacoemulsification was performed targeting -0.50 D in the non-dominant eye. At 3 months, the primary outcome is binocular mesopic contrast sensitivity (CS) without glare (CSV-2000). Secondary outcomes included binocular target-corrected distance, intermediate, and near visual acuity (TCDVA, TCIVA, TCNVA), post-operative spherical equivalent (SE), mesopic CS with glare and photopic CS, uncorrected visual acuity (UCVA) and patient-reported outcomes (QUVID, IOLSAT).
Results
136 patients (272 eyes; 71 men, 65 women; mean age of 67.8± 7.8 y) were enrolled. 68 completed 3-mo follow-up to date; 35 received AcrySof, 33 Clareon Vivity. Binocular mesopic CS (median [IQR]) was 1.97 (1.97-1.97) at 1.5 cpd, 2.29 (2.29-2.90) at 3 cpd, 1.99 (1.69-1.99) at 6 cpd, and 1.10 (0.81-1.40) at 12 cpd. Median CS difference between Clareon and Acrysof was 0.00006 at 3cpd (p=0.58), smaller at other frequencies. Median (IQR) TCDVA, TCIVA, TCNVA were 0.00 (-0.09-0.00), 0.10 (0.00-0.20), 0.30 (0.00-0.40) logMAR. Median (IQR) SE was 0.00 (-0.25-0.00) D in the dominant eye, and -0.25 (-0.50-0.00) D in the non-dominant. Most patients (90%) were satisfied with their vision after surgery.
Conclusion
Early outcomes of both Clareon and Acrysof Vivity were similar.
Presenting Author
Barbara Kusa, MD
Co-Authors
Matteo Piovella (MD)
Purpose
To evaluate results in refractive cataract surgery in eyes implanted with trifocal IOLs to get distance intermediate and near vision. IOLs with different Haptics design, close vs traditional were compared when implanted in complicated cases
Methods
925 eyes were implanted with trifocal IOLs.435 eyes with ATLISA tri 839MP (close haptic)-Carl Zeiss Meditec AG Jena and 490 eyes were implanted with AT LISA tri 949MP.Mean Age 66.53 ±11.50. Biometry was performed with IOL Master 700 RK and astigmatism axis alignment performed with Callisto system. Blephex Lipiflow and ILux were applied 52 eyes were implanted with Elana IOL traditional Haptic - Carl Zeiss Meditec.
Results
At 11 years monocular Trifocal IOLs results are UCDVA 20/22 ± 2.40 UCIVA 20/24 ± 3.13 UCNVA 20/27 ± 5.37,monocularToric Trifocal IOLs are UCDVA 20/20 ± 3.25 UCIVA 20/35 ± 4.75 UCNVA 20/29 ± 2.56 Binocular results(178 patients)are UCDVA was 20/20, intermediate 20/20 and near vision 20/24.97. Conclusion:AT LISA tri and tri toric trifocal IOLs provide glass free vision after cataract surgery. Data show that it is possible to adopt them in the great majority of patients. In 2024 we started implanting Elana IOLs - Hydrophobic lens material with traditional c loop haptic. Same visual results but better centration when implanted in the sulcus in case of opening of the posterior capsule
Conclusion
AT LISA tri and tri toric trifocal IOLs provide glass free vision after cataract surgery. Data show that it is possible to adopt them in the majority of patients New Elana IOL Carl Zeiss Meditec , Hydrophobic lens material cloop haptic provides better IOL centration when implanted in sulcus
Presenting Author
Daniel H. Chang, MD
Co-Authors
Andrew Kao (MD), Laura Huggins (OD), Brittany Camirand (BSc)
Purpose
To compare the Tecnis Odyssey Full Visual Range IOL (models DRN00V and DRT150) with the Tecnis Symfony Extended Depth of Focus IOL (models ZXR00 and ZXT150) in terms of visual performance, post-op symptoms (blurred vision and dysphotopsias), post-op counseling, and needed secondary interventions (YAG capsulotomies and enhancements).
Methods
This is a retrospective, single-center review with follow-up through 9 months. Consecutive eyes implanted with models DRN00V/DRT150 (N = 57) or ZXR00/ZXT150 (N = 63) during the first 6 months of lens availability and adoption were reviewed. Key endpoints include 1 and 3 month UDVA, UNVA, and manifest refraction. Percentage of patients complaining of blurred vision and dysphotopsias, needing post-op counseling on dysphotopsias, posterior capsular opacification, or enhancements, and undergoing YAG laser capsulotomies, enhancements, or other interventions will be reported.
Results
At 3 months, DRN/DRT had better UNVA than ZXR/ZXT (0.13 ± 0.07 logMAR vs 0.34 ± 0.16 logMAR, p < 0.001). DRN/DRT also had fewer complaints of blurred DVA and blurred NVA than ZXR/ZXT (4.9% and 4.9% vs 17.9% and 42.9%, p =0.001 and <0.001, respectively). Dysphotopsia complaints were similar (24.4% vs 25.0%, p = 0.33). DRN/DRT required less post-op counseling than ZXR/ZXT for dysphotopsias (7.3% vs 28.6%, p < 0.001), posterior capsular opacification (7.3% vs 28.6%, p < 0.001), and enhancements (2.4% vs 35.7%, p < 0.001). DRN/DRT required similar YAG laser capsulotomies as ZXR/ZXT (7.0% vs 8.3%, p = 0.57), but DRN/DRT required fewer enhancements than ZXR/ZXT (1.8% vs 5.0%, p = 0.045).
Conclusion
DRN/DRT and ZXR/ZXT both demonstrate excellent visual outcomes and low enhancement rates. At 3 months, DRN/DRT show improvements in UCNVA, visual quality complaints, post-op counseling, and laser vision correction enhancements, suggesting a real-world improvement in visual range and functional tolerance to residual refractive error over ZXR/ZXT.
