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Moderator
Manoj V. Motwani, MD
Panelists
Alexander Knezevic, MD; 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
Benjamin Stern, MD
Co-Authors
Damien Gatinel (PhD, MD)
Purpose
To investigate how post-refractive corneal shapes interact with multifocal IOL designs and how these interactions influence optical quality, contrast, and depth of focus. With the growing number of cataract patients after LASIK and the absence of clear implantation guidelines, model-based evaluation is increasingly needed.
Methods
Post-LASIK corneal models were created for mild, moderate, and high myopic treatments, as well as mild, moderate, and high hyperopic treatments. Ten commercially available multifocal IOL designs were studied, representing a spectrum of optical principles, from apodized diffractive platforms to lenses with large diffractive step heights concentrated in the mid-periphery. Using an optical bench system, modulation transfer function (MTF) through-focus curves were obtained at multiple spatial frequencies, and averages from 0 to 100 lp/mm were calculated. For each corneal-IOL combination, maximal distance contrast and effective depth of focus were quantified and compared.
Results
Post-myopic and post-hyperopic corneas demonstrated markedly different interaction patterns with multifocal IOL optics. Each type of ablation induced unique spherical aberration profiles, which in turn altered contrast transfer and depth of focus in distinct ways. Modelization of these interactions showed that not all multifocal IOLs performed equally in such cases, with certain designs displaying greater adaptability than others..
Conclusion
Multifocal implantation in eyes with prior refractive surgery presents unique challenges due to the altered spherical aberration profiles of post-myopic and post-hyperopic corneas. These results underscore the need for individualized IOL selection strategies and suggest that a model-based approach may offer a framework for optimizing outcomes.
Presenting Author
Carlos Palomino, Sr., MD, PhD, FEBO
Co-Authors
Ricardo Cui�a Sardi�a (PhD, MD, FEBO)
Purpose
To analyze the behavior and defocus curve of a new trifocal intraocular lens (Asqelio, AST) compared to two other trifocal intraocular lenses: FineVision (PhysIOL) and AT Lisa Tri (Zeiss).
Methods
The study was prospective and observational in which a total of 150 eyes of 75patients were included, of which 25 patients were implanted bilaterally with theAsqelio intraocular lens, 25 patients with FineVision and 25 patients with AT Lisa.Three months after surgery, the defocus curve (+3.00 to -5.00 D) was obtained usingthe ETDRS optotype in logMAR. Refraction and distance, intermediate and nearvisual acuity were performed at one and three months. SPSS 28.0.1 was used toanalyze the data.
Results
Three months after surgery, the Asqelio group showed a mean DCVA of -0.05±0.06,ICVA of 0.21±0.09 and NCVA of 0.08±0.08; the FineVision group showed an DCVA of0.04±0.04, ICVA of 0.12±0.05 and NCVA of 0.09±0.05 and the AT Lisa group showedan DCVA of 0.05±0.05 , ICVA of 0.19±0.03 and NCVA of 0.13±0.15. For the Asqeliogroup, the defocus curve in distance vision showed an average of -0.04±0.07,0.03±0.08 and 0.04±0.08D in distance, intermediate and near distance respectively.For the FineVision group, a visual acuity of 0.01±0.03, 0.31±0.08 and 0.20 ± 0.02was obtained, respectively, and for the AT Lisa group, 0.04±0.05D, 0. 14±0.04D and0.15±0.04D respectively.
Conclusion
Refractively, the three groups showed good results. The best visual acuity in distanceand was obtained by the Asqelio group and in intermediate by the FineVision group.The defocus curve, for the entire range from distance vision to near vision, showedthat the best visual performance comes from the Asqelio lens.
Presenting Author
Carlos Palomino, Sr., MD, PhD, FEBO
Co-Authors
Ricardo Cui�a Sardi�a (PhD, MD, FEBO)
Purpose
Compare the visual performacnce of five trifocal premium IOLs and determine wichis better for each tipe of patient and them visual needs
Methods
250 eyes of 125 patiets were included in this prospective study: 50 eyes wereimplanted with AT Lisa Tri 839 (Zeiss), 50 eyes with Finevision (Physiol), 50 eyeswith Synergy (JJ VIsion), 50 eyes with Panoptix (Alcon) and 50 eyes with Asqelio(AST). The visual acuity at distance (4m), intermediate (66 cm) and near (40 cm)were performed with ETDRS test in LogMAR. Also defocus curve were determinedfor all patients of each tipe of IOL, showing the best behavior of each lens for alldistances. Ray tracing total aberrometry were measured with iTrace (Tracey technologies) and objetive quality of vision were studied. Data were analized withSPSS 20.0 (IBM)
Results
The postop mean of visual acuity for disntance, intermediate and near for AT Lisa Tri839 were 0.05±0.05, 0.19±0.03 and 0.13±0.15 respectively. For Finevision were0.04±0.04, 0.12±0.05 and 0.09±0.15 respectively.For Synergy were -0.04±0.04,0.02±0.06 and 0.06±0.04 respectively.For Panoptix were -0.06±0.02, 0.03±0.04 and0.13±0.5 respectively. And for Asqelio were -0.05±0.06, 0.21±0.09 and 0.14±0.08respectively.
Conclusion
At the measured distance, Panoptix and Asqelio show the best results for distancevisual acuity. For near Synergy show the best results. We have to select the correctIOL for each patient, attending to the visual needs and the addition of lens.
Presenting Author
Carlos Palomino, Sr., MD, PhD, FEBO
Co-Authors
Ricardo Cui�a Sardi�a (PhD, MD, FEBO)
Purpose
To evaluate the visual and refractive outcomes, as well as subjective and objective depth of field (DOF), following implantation of a continuous transitional focus (CTF) intraocular lens (Precizon Presbyopic NVA IOL) in patients undergoing cataract surgery.
Methods
A prospective study was conducted on 50 eyes of 25 patients bilaterally implanted with the Precizon Presbyopic NVA IOL. Visual acuity was evaluated 3 months postoperatively, including UDVA, CDVA, UIVA, and UNVA. Subjective DOF was assessed using defocus curves under photopic conditions, with absolute (VA ? 0.2 logMAR) and relative (0.2 logMAR drop) criteria. Objective DOF was measured under scotopic conditions with the iTrace aberrometer using the visual Strehl ratio (VSOTF) at 90%, 80%, and 60% degradation thresholds. Photic phenomena were evaluated using the validated Quality of Vision questionnaire, assessing frequency, intensity, and bothersomeness.
Results
At 3 months, UDVA and CDVA reached -0.01 ± 0.12 and -0.05 ± 0.10 logMAR, while UIVA and UNVA were 0.15 ± 0.10 and 0.16 ± 0.12 logMAR. Subjective absolute and relative DOF were 2.22 ± 0.80 D and 1.75 ± 0.90 D, respectively. Objective DOF measured by VSOTF was 0.66 D (90%), 1.17 D (80%), and 2.03 D (60%). A significant negative correlation was found between absolute subjective DOF and VSOTF 60% (? = -0.337; p = 0.017). Glare and halos were not experienced by 96% and 92% of patients, respectively. Starbursts were more frequent but mostly reported as mildly bothersome.
Conclusion
The CTF Precizon Presbyopic IOL provided excellent visual outcomes and a continuous range of functional vision from distance to near. Subjective DOF was higher than objective measures, with VSOTF 60% showing the best correlation. Photic phenomena were minimal, indicating high patient satisfaction.
Presenting Author
Hugo F. Borges, MD
Co-Authors
Karolinne Rocha (MD, PhD), Rupal Trivedi (MD)
Purpose
To assess the tolerance to simulated astigmatism and patient-reported outcomes in pseudophakic eyes implanted with a violet light-filtering diffractive fullrange of vision (VLF FVR) intraocular lens (IOL).
Methods
This prospective, observational study included thirty patients who had cataract surgery with the implantation of a VLF FVR IOL. Visual outcomes were assessed 1-3 months postoperatively. Cylindrical defocus was induced using +0.50 to +2.00 D cylinder lenses in 0.50D increments for with-the-rule (WTR), oblique, and against-the-rule (ATR) orientation over the patient's corrected distance refraction. The tolerance to simulated astigmatism was evaluated by calculating the difference between distance visual acuity (VA) at each defocus and corrected distance VA without defocus. The patient's reported outcomes were analyzed using the assessment of IOL implant symptoms (AIOLIS) questionnaire.
Results
Visual acuity declined with increasing induced astigmatism across all axis orientations. More than 90% of eyes achieved 20/40 or better distance visual acuity with up to 1.50 D of with-the-rule (WTR) astigmatism and up to 1.00 D of against-the-rule (ATR) or oblique astigmatism. At 1.00 D of induced astigmatism, WTR orientation demonstrated significantly better visual acuity compared with ATR (P = .04) and oblique (P = .03). Patient-reported outcomes showed high spectacle independence (96.6%) and low rates of severe dysphotopsias.
Conclusion
This violet light-filtering full-range vision IOL demonstrated good tolerance to residual astigmatism for distance vision, with better performance in the with-the-rule orientation compared with against-the-rule and oblique astigmatism. Patient-reported outcomes showed high satisfaction and a low incidence of clinically relevant optical phenomena.
Presenting Author
George O. Waring, IV, MD
Co-Authors
Victoria Fernandes (MD), Karolinne Rocha (MD, PhD)
Purpose
Evaluate clinical defocus curves for patients who have previously undergone uncomplicated cataract surgery with bilateral implantation of Tecnis Odyssey IOLs.
Methods
In this prospective, observational study, patients aged 40 or older who had already undergone bilateral implantation of Tecnis Odyssey IOLs were recruited for additional evaluation of clinical defocus under photopic conditions at 3±2 months following IOL implantation. All patients had postoperative astigmatism ? 0.75 D. Using the "push plus" method, the patient's manifest refraction was placed in the phoropter, and ETDRS visual acuity testing was performed at the following levels of defocus: +2.00 +1.50, +1.00, +0.50, +0.25, -0.25, -0.50, -1.00, -1.50, -2.00, -2.50, -3.00, and -3.50 D. Demographic and other pre- and post-operative characteristics were also recorded.
Results
Mean MRSE was 0.04 LogMAR OD and 0.08 OS. All eyes were within 1.00 D of emmetropia, and 94.1% were within 0.5 D. The monocular defocus curve showed that in the intermediate and near-vision ranges (-1.0 to -2.5 D), the Tecnis Odyssey IOL demonstrated a visual acuity range of 0.10 to 0.21 logMAR (20/25 to 20/32.4). Binocular defocus curve showed that in the intermediate and near vision range (-1.0 to -2.5 D), the Tecnis Odyssey IOL demonstrated a visual acuity range of 0.04 to 0.12 LogMAR (20/22 to 20/26). The IOL exhibited a binocular range of vision of 0.13 LogMAR (20/27) or better across a 4.0 D defocus range from +1.0 to -3.0 D.
Conclusion
Defocus curve analysis showed that the Tecnis Odyssey IOL demonstrated excellent visual acuity in the near and intermediate vision ranges.
Presenting Author
Robert F. Melendez, MD, MBA
Purpose
To evaluate visual and refractive outcomes following implantation of a hydrophobic acrylic trifocal toric intraocular lens (IOL) in patients with prior myopic refractive surgery.
Methods
This was a single-arm, single surgeon, prospective, observational study of visual and refractive outcomes 3 months following successful cataract surgery. A total of 80 eyes of 40 subjects were targeted. Subjects were implanted with the Clareon PanOptix spherical or T3 toric IOL. Study outcome measures included binocular and monocular uncorrected and distance corrected visual acuity at distance (UDVA, CDVA), intermediate (UIVA, DCIVA; 60cm), and near (UNVA, DCNVA; 40cm and 33cm), and administration of the QUVID and IOLSAT questionnaires.
Results
To date, 45 eyes have completed a 1 month postoperative visit. Mean monocular visual outcomes were 0.11 ± 0.16 logMAR (UDVA), 0.09 ± 0.15 logMAR (UIVA), 0.03 ± 0.10 logMAR (UNVA), 0.00 ± 0.09 logMAR (CDVA), 0.00 ± 0.02 logMAR (DCIVA), and -0.02 ± 0.00 logMAR (DCNVA). In addition, the percentage of eyes 20/20 or better were 36% (UDVA), 62% (UIVA), 73% (UNVA), 84% (CDVA), 94% (DCIVA), and 100% (DCNVA).
Conclusion
Interim results suggest good visual outcomes and high patient satisfaction with PanOptix Pro and PanOptix Pro toric IOL implantation in post myopic refractive surgery patients.
Presenting Author
Ken Hayashi, MD, PhD
Co-Authors
Koichi Uno (MD), Shunsuke Hayashi (MD), Motoaki Yoshida (MD)
Purpose
To compare visual outcomes among three age groups in eyes with a trifocal intraocular lens (IOL) or an enhanced monofocal IOL.
Methods
Seventy-eight eyes of 78 patients who received a trifocal IOL (trifocal category) and 78 eyes of 78 patients who received an enhanced monofocal IOL (enhanced monofocal category) were enrolled. Patients were stratified by age decade (n=26/group): 40-59 years of age (40s & 50s), 60-69 years of age (60s), and 70-79 years of age (70s). Uncorrected and distance-corrected visual acuity (VA) at various distances and photopic and mesopic contrast VA were examined at 3 months postoperatively and compared among age groups.
Results
No significant differences in the mean uncorrected and distance-corrected VAs were detected at almost all distances among the three age groups for either the trifocal or enhanced monofocal category. Mean photopic contrast VA was significantly different among the three age groups at 100% contrast for the trifocal category (P=0.018) and at 25%, 10%, 5%, and 2.5% contrasts in the enhanced monofocal category (P?0.005); it was significantly better in the 40s & 50s age group than in the 60s or 70s age group (P?0.002).
Conclusion
All-distance VA in eyes with a trifocal IOL and an enhanced monofocal IOL was comparable among patients 40-79 years of age although contrast sensitivity was significantly worse in older patients, suggesting that these IOLs can be implanted irrespective of age with careful consideration of the age-related decline in contrast sensitivity.
Presenting Author
Mark C. Lobanoff, MD
Purpose
In the past year, three new trifocal IOLs have entered the US market: Odyssey, Panoptix Pro, and Envy. How do these lenses perform in a typical cataract surgery clinic? How good is the near, intermediate, and distance uncorrected vision for each lens? What patient reported outcomes on vision quality differentiate them?
Methods
Retrospective analysis of outcomes by a single surgeon. First arm of the study, three study groups comprised of 40 eyes in each. Each group received a different IOL (Odyssey, Panoptix Pro, or Envy). Uncorrected visual acuity was measured at near, intermediate and far at 3 month post-op visits. After 40 eyes, the two IOLs with the best outcomes were allowed to continue. The second arm of the study examined 200 eyes implanted with the Envy and 200 eyes implanted with the Panoptix Pro. Patients were asked to complete a modified PROWL questionnaire on vision quality and satisfaction with the lens. Patient selection required they be free of any corneal or retinal pathology .
Results
TBD
Conclusion
TBD
Presenting Author
Sanem Belgin, MD, FEBO
Co-Authors
Sibel Ahmet (FEBO, FRCSEd, MD), Nilay kandemir Besek (MD), Ahmet Kirgiz (FEBO)
Purpose
To evaluate clinical outcomes and patient satisfaction regarding visual function after cataract surgery with a novel trifocal intraocular lens (IOL) incorporating a sinusoidal diffractive optical design.
Methods
This prospective study was conducted between February and September 2025 at Beyoglu Eye Training and Research Hospital. Thirty patients without ocular comorbidities underwent bilateral phacoemulsification with implantation of a sinusoidal trifocal IOL. Examinations were performed preoperatively and at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. Assessments included visual acuity (VA), contrast sensitivity (CS), dysphotopsia, optical biometry, corneal topography, specular microscopy, and optical coherence tomography. Patient-reported outcomes were evaluated using the NEI VFQ-25 questionnaire.
Results
At 6 months, mean monocular UDVA, UIVA, and UNVA were -0.016±0.045, 0.113±0.075, and 0.082±0.068 logMAR, respectively. UDVA and CDVA did not differ between photopic and mesopic conditions (p=0.276), whereas UIVA, UNVA, CIVA, and CNVA were significantly better under photopic conditions (all p<0.05). CS showed no significant photopic-mesopic differences with or without glare (all p>0.05), but photopic CS values exceeded reference across spatial frequencies in patients aged 50-75 (p=0.0001). The binocular defocus curve demonstrated VA better than 0.1 logMAR from -3.00D to +1.50D. Halos and glare were reported by 10% and 3% of patients, respectively.
Conclusion
The novel sinusoidal diffractive trifocal IOL provides high-quality vision at distance, intermediate, and near ranges, preserves contrast sensitivity with minimal dysphotopsia, and enhances patient satisfaction by delivering outcomes approaching physiological vision.
Presenting Author
Christopher Schiefer, MD
Co-Authors
Renee Bondurant (BSc), Robert Weinstock (MD), Neel Desai (MD), Juan Vila (BEng)
Purpose
To compare visual acuity outcomes and patient-reported visual quality among cataract patients implanted with four advanced multifocal intraocular lenses (IOLs): FineVision, PanOptix Pro, Odyssey, and Envy.
Methods
This retrospective, non-randomized study will review approximately 132 patients (33 per IOL group) who underwent routine cataract surgery with implantation of FineVision, PanOptix Pro, Odyssey, or Envy multifocal IOLs. Three arms will be analyzed: FineVision vs. PanOptix Pro, Odyssey vs PanOptix Pro, and Envy vs PanOptix Pro. PanOptix served as the common comparator across all three arms. Eligible patients had no ocular or systemic comorbidities limiting visual potential. Outcomes at 1 month will include uncorrected and best-corrected distance and near visual acuity, plus patient-reported satisfaction (distance and near) and ratings of halos/starbursts, and glare (1-10 scale).
Results
Postoperative data will be analyzed to compare visual acuity and patient-reported measures across the three study arms. Statistical testing will evaluate differences in visual performance and subjective visual symptoms between each test lens and the PanOptix Pro reference group. The complete results of this analysis will be presented.
Conclusion
This study will assess visual outcomes and patient experience with four advanced multifocal IOLs to inform lens selection and counseling for cataract surgery.
Presenting Author
Sarah Rahman, MD
Co-Authors
David Oh (MD), Kevin Everett (MD), Akash Gupta (MD, MBA)
Purpose
What is the difference in visual acuity outcomes between different multifocal lenses (Panoptix Pro and Odyssey)?
Methods
We conducted a retrospective chart review of patients who underwent implantation of a Panoptix Pro or Odyssey (or Toric equivalent) intraocular lens by a single surgeon at one institution from January 2025 through August 2025 (with plan to collect more data in the coming months). A total of 62 eyes were included, 9 of which had a Panoptix Pro or Panoptix Pro Toric and 53 of which had an Odyssey or Odyssey Toric lens implanted. Primary outcomes were uncorrected visual acuity at distance, intermediate, and near at the 1 month postoperative visit.
Results
Preliminary results reveal the average logMAR value for distance vision was 0.124 and 0.00670 for the Panoptix Pro and Odyssey intraocular lenses respectively (p=0.025). For intermediate distance, it was 0.0896 and 0.186 for the Panoptix Pro and Odyssey intraocular lenses respectively (p=0.017). For near, it was 0.0658 and 0.169 for the Panoptix Pro and Odyssey intraocular lenses respectively (p=0.062).
Conclusion
Eyes with Odyssey lenses had statistically significant better distance vision when compared with Panoptix Pro lenses, though the Panoptix Pro lenses had statistically significant better intermediate vision. While the Panoptix Pro lenses did have better near vision than Odyssey lenses on average, the difference was not statistically significant.
