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Moderator
Daniel H. Chang, MD, ABO
Panelists
Ashraf F Ahmad, MD, ABO; Kamran M. Riaz, 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
Alice T. Epitropoulos, MD, FACS
Purpose
This retrospective case series aims to document healthcare providers’ (HCP) real-world experience of using the enVista ENVY toric (ETN) intraocular lens (IOL), including satisfaction, IOL utilization patterns, and patient outcomes. This interim sub-analysis reports the patient outcomes.
Methods
This sub-analysis of a multicenter, cross-sectional, retrospective case series includes case report forms (CRFs) from 11 HCPs from the USA (n=10) and Canada (n=1). HCPs provided ETN electronic medical record cases using a standardized CRF to document real-world clinical performance. Key outcome measures included monocular and binocular vision outcomes (uncorrected distance visual acuity [UDVA], corrected distance visual acuity [CDVA], uncorrected intermediate visual acuity [UIVA], uncorrected near visual acuity [UNVA]), mean refractive spherical equivalent (MRSE), and adverse events (AEs).
Results
Preliminary analysis included 110 pts (168 eyes): 52 unilateral. Mean±SD preop delta K and spherical equivalent target were 1.05±0.53 and –0.04±0.21 (n=167). Monocular vision outcomes were: CDVA of 20/25 or better was achieved in 94% of eyes (n=124); UDVA of 20/32 or better in 83% of eyes (n=151); UIVA of 20/32 or better in 89% of eyes (n=78); UNVA of J2 or better in 66% of eyes (n=118). Mean±SD MRSE and residual cylinder were –0.15±0.42 and –0.46±0.43 (n=111), respectively. No serious adverse events reported.
Conclusion
In the cases provided, most patients achieved good distance, intermediate, and near vision, with no reported glistening.
Presenting Author
Edward H Hu, MD, PhD
Purpose
To assess the visual outcomes at distance, intermediate, and near following the implantation of a full visual range IOL in cataract surgery patients.
Methods
This retrospective study included patients who had undergone bilateral implantation of a full visual range IOL (enVista Envy IOL, Bausch and Lomb). Outcome measures included assessment of monocular uncorrected visual acuities at distance, intermediate, and near at postoperative 3 weeks.
Results
Postoperatively, the data of 16 eyes (8 patients) were available for analysis. The mean logMAR UDVA was 0.12±0.14 with 81.3% of eyes achieving UDVA of 20/30 or better postoperatively. The mean postoperative manifest refraction spherical equivalent (MRSE) was -0.30 ± 0.35 D, with 87.5% of eyes achieving MRSE within 0.50 D. The mean UNVA was 0.12±0.09 logMAR, with 71.4% of eyes achieving UNVA of 20/25 or better, postoperatively. The mean UIVA was 0.06±0.08 logMAR, with 85.7% of eyes achieving UIVA 20/25 or better.
Conclusion
enVista Envy full visual range IOL implanted in cataract patients showed good visual outcomes at distance, intermediate and near.
Presenting Author
Habeeb Ahmad, MD, MS
Co-Authors
Kelly Liu (OD), Linda Tsai (MPH)
Purpose
To report multicentric real-world clinical tolerance to residual refractive error outcomes of a new purely refractive EDOF IOL.
Methods
This is an ambispective, multicenter, observational, single-arm, single-visit study in subjects bilaterally implanted with a new purely refractive EDOF IOL in Europe and Asia Pacific. Sub-analysis included ametropic subjects that had at least one eye with magnitude of absolute post-op spherical equivalent (SEQ) ? 0.50 and ? 1.00 D AND/OR astigmatism > 0.50 and <1.50 D vs emmetropic subjects with post-op SEQ -0.25 to +0.25 D AND astigmatism ? 0.50 D in both eyes. Mean binocular uncorrected distance visual acuity (UDVA), patient satisfaction with uncorrected overall vision, and need for distance glasses at 3-months post-op will be presented.
Results
Sub-analysis included data for 147 ametropic subjects and 110 emmetropic subjects. Mean binocular UDVA were -0.03 ± 0.07 and -0.02 ± 0.09 logMAR for ametropic and emmetropic subjects, respectively. In our cohort, 91% and 96% of ametropic and emmetropic subjects did not need spectacle correction for distance, respectively. Notably, 92% and 95% of ametropic and emmetropic subjects, respectively, were completely or mostly satisfied with their uncorrected overall vision.
Conclusion
Real-world data for the new purely refractive EDOF IOL demonstrated high quality distance vision and tolerance to post-op refractive errors. Patients achieved excellent uncorrected distance VA, high spectacle independence for distance, and high satisfaction with their overall vision despite residual post-op refractive error.
Presenting Author
Adam K. Muzychuk, MD, FRCSC
Purpose
This retrospective case series aimed to document healthcare providers’ (HCP) real-world experience of using the enVista ENVY (EN) intraocular lens (IOL), including satisfaction, IOL utilization patterns, and patient (pt) outcomes. This interim sub-analysis reports the pt outcomes.
Methods
This sub-analysis of a retrospective, multicenter, cross-sectional study includes case report forms (CRFs) from 13 HCPs from the USA (n=12) and Canada (n=1). HCPs provided on-label EN electronic medical record cases using a standardized CRF to document real-world clinical performance. Key outcome measures included monocular and binocular vision outcomes (uncorrected distance visual acuity [UDVA], corrected distance visual acuity [CDVA], uncorrected intermediate visual acuity [UIVA], uncorrected near visual acuity [UNVA]), mean refractive spherical equivalent (MRSE), occurrence of glistenings and posterior capsule opacification (PCO), and adverse events (AEs).
Results
The analysis included 94 pts (144 eyes): 44 unilateral, 50 bilateral. Mean±SD spherical equivalent target was 0.05±1.91 (n=135). Monocular CDVA of 20/≤25 was achieved in 98% of eyes (n=116); UDVA of 20/≤32 in 88% of eyes (n=117); UIVA of 20/≤32 in 91% of eyes (n=53); UNVA of ≤J2 in 78% of eyes (n=88). Binocular CDVA of 20/≤25 was achieved in 100% of pts (n=42). Mean±SD MRSE was −0.09±0.38 (n=116). No serious AEs were reported. No pts reported glistening.
Conclusion
This multicentre, cross-sectional, retrospective study provides insights into the real-world vision outcomes and clinical performance of EN. Most patients achieved good distance, intermediate, and near vision outcomes with no reported glistening. No serious AEs or glistening were reported.
Presenting Author
Ahad Mahootchi, MD
Purpose
To evaluate the spectacle independence and frequency of visual symptoms following bilateral implantation of a full visual range (FVR) IOL.
Methods
This retrospective chart review included 78 patients who underwent cataract surgery and implantation of an FVR IOL (enVista Envy, Bausch & Lomb). This IOL is designed to provide a continuous range of vision, enhancing both near and distance vision. Outcome measures were subjective assessment of spectacle independence and incidence of visual symptoms using the patient-reported spectacle independence (PRSIQ).
Results
The percentage of patients who responded that they wore glasses or contacts ‘none’ or ‘a little of the time’ was 100% for distance and intermediate, and 92.9% for near vision. The proportion of patients who reported that they could function comfortably ‘all or most of the time’ without wearing glasses or contacts was 100% for distance, 96.4% for intermediate, and 89.2% for near vision. The proportion of patients who reported visual symptoms ‘some’, ‘a little’, or ‘none of the time’ was 89.3% for glare, 82.1% for halos, and 92.9% for starbursts.
Conclusion
The FVR IOL demonstrated excellent spectacle independence for distance, intermediate, and near vision. The minimal occurrence of visual disturbances contributed to good IOL performance and high levels of overall patient satisfaction.
Presenting Author
Brian Schwam, MD
Co-Authors
Daniel Cheng (OD), Linda Tsai (MPH)
Purpose
To report multicentric real-world quality of vision results of a purely refractive Extended Depth of Focus (EDOF) PCIOL.
Methods
This is an ongoing, ambispective, multicenter, observational, single-arm, single-visit study in patients bilaterally implanted with the EDOF IOL. Interim Quality of Vision outcomes from the single 3-month post-op prospective visit are reported from 17 sites in Europe and Asia Pacific. Mean binocular and monocular uncorrected distance visual acuity (UCDVA) and best-corrected distance VA (BCDVA), and binocular uncorrected intermediate (66cm) VA (UCIVA) and distance-corrected intermediate VA (DCIVA), are reported in logMAR (with Snellen equivalent). Postoperative manifest refraction spherical equivalent (MRSE), other VA endpoints, and visual symptoms are also reported.
Results
289 subjects (578 eyes) previously implanted with the TECNIS PureSee IOL underwent a 3-month post operative visit. Mean ± SD post-op binocular UCDVA was -0.02 ± 0.08 (20/19), BCDVA was -0.06 ± 0.07 (20/18), UCIVA was 0.12 ± 0.11 (20/26), and DCIVA was 0.11 ± 0.10 (20/26). Mean monocular UDVA was 0.04 ± 0.10 (20/22) and BCDVA was -0.03 ± 0.07 (20/19). Mean post-op MRSE was -0.02 ± 0.40 D. The proportions of subjects achieving 0.0 logMAR or better binocular UCDVA and BCDVA were 89.7% and 97.6%, respectively. Most patients did not experience or were “not at all” or “a little” bothered by glare (91%), halos (93%), and (92%) starbursts, respectively.
Conclusion
The real-world results for the purely refractive EDOF IOL show excellent distance and intermediate vision and low levels of bothersome visual symptoms consistent with high quality of vision.
Presenting Author
Kerry D. Solomon, MD
Co-Authors
Vidhyapriya Sreenivasan (PhD), Jessie Hull (PhD), Zachary Zavodni (MD), Trina Patel (PhD)
Purpose
To evaluate visual outcomes of a next generation trifocal, Clareon PanOptix Pro (CPO Pro) designed to offer more light energy utilization, less light scatter and enhanced image contrast in far intermediate region.
Methods
Prospective, multicenter, randomized, assessor and subject masked, contralateral, active controlled clinical trial compared Clareon PanOptix Pro vs. Clareon PanOptix (CPO). Adult subjects with bilateral cataracts and less than 1.00 D of preoperative corneal astigmatism underwent IOL implantation and followed for 6m post-operatively. Monocular visual acuity (VA) was measured at far, intermediate and near. Patient preference for clarity of letters was assessed by presenting high contrast photopic 0.2 logMAR line on the VA chart at 40cm, 66cm, 120cm and 4m. Patient preference for visual disturbance (Halo and Starburst) assessed by presenting pen light stimulus at 4m with room light off.
Results
A total of 83 subjects underwent implantation of CPO Pro in one eye and CPO in the other. CPO Pro showed non-inferior VA compared to CPO at far (4m), intermediate (66cm) and near(40cm), with a mean difference < 0.02 logMAR (< one letter). Patient preference regarding clarity of letters trended towards more subjects favoring CPO Pro over CPO at far and far-intermediate (4m: CPO Pro preferred by 57% vs 34% CPO; 120cm: CPO Pro preferred by 59% vs 32% CPO). At intermediate (66cm) and near (40cm), preferences were evenly split between the two lenses. For patient preference on visual disturbances, 49 % preferred CPO Pro over 29% CPO for starbursts, and 43 % preferred CPO Pro over 21% for halos.
Conclusion
The results of this clinical study demonstrate that CPO Pro provides non-inferior visual acuity at key distances compared to Clareon PanOptix. Additionally, patient preference trends favored CPO Pro for far-intermediate distances and for reduced visual disturbances, such as halos and starbursts.
Presenting Author
Shannon M. Wong, MD
Co-Authors
Jacob Wong (BA), Ryan Wong (MSc, BSc)
Purpose
To evaluate real-world clinical outcomes in patients undergoing bilateral cataract surgery with implantation of a novel full visual range (FVR) intraocular lens (IOL).
Methods
This retrospective chart review included patients who underwent bilateral cataract surgery with implantation of the enVista Envy FVR IOL (Bausch + Lomb). Patients with a history of LASIK were excluded. Outcome measures included uncorrected and corrected distance visual acuity (UDVA, CDVA) and uncorrected near visual acuity (UNVA) at 1-month follow-up.(302/700 characters)
Results
Data from 110 eyes (55 patients) were analysed. Mean postoperative UDVA was 0.07 ± 0.09 logMAR, with 94.5% of eyes achieving 20/30 or better. Mean CDVA was 0.03 ± 0.07 logMAR, with 98.2% eyes achieving 20/30 or better. Mean UNVA was -0.04 ± 0.09 logMAR, with 99% of eyes achieving 20/30 or better. Mean MRSE was -0.09 ± 0.33 D, with 90% of eyes within ±0.50 D. (448/700 characters)
Conclusion
Bilateral Implantation of enVista Envy FVR IOL showed excellent visual outcomes in real-world settings, with 94.5% and 99% of eyes achieving uncorrected visual acuity of 20/30 or better at distance and near, respectively. (211/350 characters)
Presenting Author
Daniel H. Chang, MD
Co-Authors
Kelly Liu (OD), Linda Tsai (MPH)
Purpose
To evaluate the visual performance and patient reported outcomes of a new purely refractive extended depth of focus IOL as compared to a standard aspheric monofocal IOL.
Methods
This was a prospective, multicenter, randomized, subject/evaluator masked clinical study conducted in the United States (9 sites). Subjects were bilaterally implanted with the purely refractive EDOF IOL (N = 115) or a monofocal control (Model ZCB00, TECNIS 1-piece Monofocal IOL, N = 113) with all eyes targeted for plano. Monocular best-corrected visual acuity for distance (CDVA), distance-corrected visual acuities for intermediate at 66 cm (DCIVA) and near at 40 cm (DCNVA), depth of focus (DOF), dependency on glasses, and patient satisfaction were evaluated at the 6-month visit.
Results
The mean ±SD of monocular logMAR CDVA was -0.04 ± 0.083 for EDOF and -0.08 ± 0.088 for control. DCIVA was 0.15 ± 0.112 for EDOF and 0.31 ± 0.148 for control, and DCNVA was 0.34 ± 0.113 for EDOF and 0.49 ± 0.160 for control—1.5-lines of improvement for both ranges. Monocular DCIVA of 0.20 logMAR or better was achieved in 82.3% of EDOF vs 30% of control. The DOF range over which monocular VA was 0.20 logMAR or better was -1.77 D for EDOF vs -1.13 D for control. Little or no spectacle use for overall vision was reported in 74.4% of EDOF vs 50% of control. Results in distance and intermediate VA were consistent independently of the pupil size and lighting conditions.
Conclusion
The new purely refractive EDOF IOL demonstrated improved intermediate and near vision and higher spectacle independence compared to a monofocal IOL while maintaining comparable distance vision with pupil independent performance.
Presenting Author
Shannon M. Wong, MD
Co-Authors
Ryan Wong (MSc, BSc), Jacob Wong (BA)
Purpose
To evaluate visual outcomes and patient satisfaction in patients who underwent intraocular lens (IOL) exchange surgery with a novel full visual range (FVR) IOL.
Methods
This retrospective case series included patients dissatisfied with previously implanted IOLs (Clearview 3, Tecnis Odyssey, Alcon PanOptix or a monofocal IOL) who underwent IOL exchange with the enVista Envy FVR IOL. Outcome measures included uncorrected distance and near visual acuity. Subjective patient experience was also assessed following the exchange surgery.
Results
Sixteen eyes of twelve patients underwent IOL exchange with the FVR IOL. Post-exchange, mean logMAR UDVA was 0.09±0.16, with 81.3% of eyes achieving 20/25 or better. Mean logMAR UNVA was -0.08±0.04, with 100% achieving 20/25 or better. Mean MRSE was -0.20±0.32 D. Patients exchanged from ClearView 3 to Envy reported resolution of glare, starbursts, and hazy vision. Patients exchanged from Odyssey noted fewer halos, better contrast, and improved peripheral vision. One eye that exchanged from PanOptix due to constant halos also reported improvement in subjective vision. All patients reported improved satisfaction.
Conclusion
Exchange to the enVista Envy FVR IOL provided good distance and near visual outcomes. Symptoms such as glare, starbursts, hazy vision, halos and peripheral vision blur reported with previously implanted IOLs resolved after exchange. Patients expressed high satisfaction with the Envy IOL compared to previously explanted IOLs.
Presenting Author
Adam K. Muzychuk, MD, FRCSC
Purpose
This retrospective case series aimed to document healthcare providers’ (HCPs) real-world experience of using the enVista ENVY (EN) and enVista ENVY toric (ETN) full visual range intraocular lenses (IOLs). This interim sub-analysis reports visual acuity outcomes with EN, stratified by residual refractive error.
Methods
This interim sub-analysis of a retrospective, multicenter, cross-sectional study includes case report forms (CRFs) from 14 HCPs from the USA (n=12) and Canada (n=2). HCPs provided on-label EN/ETN electronic medical record cases using a standardized CRF to document real-world clinical performance. Key outcome measures included monocular vision outcomes (uncorrected distance VA [UDVA], corrected distance VA [CDVA], uncorrected intermediate VA [UIVA], uncorrected near VA [UNVA]), manifest refraction spherical equivalent (MRSE) and residual cylinder. Outcomes were stratified by residual refractive error (sphere, cylinder, and MRSE) in 0.25 D groups. Patients were followed for ≥6 months.
Results
Eyes implanted with the EN IOL and residual sphere of –0.5 D achieved ≤20/25 UDVA, UIVA and UNVA in 25%, 100% and 100%, respectively. With a residual sphere of –0.25 D, ≤20/25 UDVA, UIVA and UNVA was achieved in 57%, 100% and 71%, respectively, and with a residual sphere of 0.00 D ≤20/25 UDVA, UIVA and UNVA was achieved in 70%, 71% and 44%, respectively. Eyes with a residual sphere of ≥+0.25 D achieved ≤20/25 UDVA, UIVA and UNVA in more than 80%, more than 82%, and more than 76%, respectively.
Conclusion
In this retrospective case series, the EN IOL provided good distance, intermediate, and near visual acuity for the majority of patients. Plano to hyperopic outcomes may lead to the best UDVA.
Presenting Author
Nitin Rangu, BA
Co-Authors
Karanpreet Multani (MD), Kamran Riaz (MD), Noah Barber (BEng)
Purpose
To determine clinical factors associated with dissatisfaction in the presence of good objective visual acuity following implantation of presbyopia-correcting intraocular lenses (IOLs) and to evaluate visual and subjective outcomes of IOL exchange in dissatisfied patients compared with satisfied controls.
Methods
Retrospective review of patients undergoing IOL exchange by one surgeon from 2019-2023 for dissatisfaction with presbyopia-correcting IOLs. Exclusions included dislocation, multiple exchanges, or insufficient follow-up. Preoperative data included demographics, IOL type, refractive error, angle alpha, angle kappa, higher order aberrations, and comorbidities. Intraoperative variables included fixation method (bag-to-bag, bag-to-sulcus, or scleral fixation) and vitrectomy. Postoperative outcomes included UDVA, CDVA, residual refractive error, and patient satisfaction. Reasons for dissatisfaction were assessed via survey, and dissatisfied patients were compared with matched satisfied controls.
Results
Fifty-two dissatisfied patients were identified; control group of 59 patients were queried. PanOptix was most commonly explanted (51.9%), followed by Vivity (13.5%) and Symfony (11.6%). Ocular comorbidities were most commonly dry eye (19.2%) and prior refractive surgery (17.3%). Dissatisfied patients had higher angle alpha values compared to controls. Intraoperatively, 40.4% underwent anterior vitrectomy; fixation was primarily bag-to-bag (55.8%) or bag-to-sulcus (32.7%). CDVA improved to 0.10 logMAR at both early and late follow-up. At ?6 months, 78.8% reported satisfaction after IOL exchange.
Conclusion
Angle alpha may be an important determinant of premium IOL candidacy. In dissatisfied patients with minimal refractive error and good objective visual acuity, IOL exchange provides favorable visual rehabilitation, excellent refractive accuracy, and restores long-term subjective satisfaction in the majority of cases.
Presenting Author
Kelly Liu, OD
Purpose
To report multicentric real-world clinical tolerance to residual refractive error outcomes of a new purely refractive EDOF IOL.
Methods
This is an ongoing, ambispective, multicenter, observational, single-arm, single-visit study in subjects bilaterally implanted with a new purely refractive EDOF IOL in Europe and Asia Pacific. Sub-analysis included ametropic subjects that had at least one eye with magnitude of absolute post-op spherical equivalent (SEQ) ≥ 0.50 and ≤ 1.00 D AND/OR astigmatism > 0.50 and <1.50 D vs emmetropic subjects with post-op SEQ -0.25 to +0.25 D AND astigmatism ≤ 0.50 D in both eyes. Mean binocular uncorrected distance visual acuity (UDVA), patient satisfaction with uncorrected overall vision, and need for distance glasses at 3-months post-op will be presented.
Results
TBD
Conclusion
TBD
