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Moderator
Kendrick M. Wang, MD
Panelists
Helga P. Sandoval, MD, MSc; Benjamin Stern, 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
Hugo F. Borges, MD
Co-Authors
Karolinne Rocha (MD, PhD), Rupal Trivedi (MD), George Waring (MD), Marcela Barros (MD), Larissa Gouvea (MD), Maya Dodhia (BSc)
Purpose
To compare tolerance to induced astigmatism (TIA) across four distinct categories of intraocular lenses (IOLs) from the same manufacturer.
Methods
Prospective observational study including 100 eyes that underwent cataract surgery with implantation of a standard monofocal, enhanced monofocal, violet light filter (VLF) extended depth of focus (EDF), or VLF full vision range (FVR) IOL. Monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected intermediate visual acuity (DCIVA) at 66 cm, and distance-corrected near visual acuity (DCNVA) at 40 cm were assessed 1-3 months postoperatively. Astigmatic defocus was evaluated after inducing 0.5 D, 1.0 D, 1.5 D, and 2.0 D of with-the-rule (WTR), oblique, and against-the-rule (ATR) astigmatism.
Results
One hundred eyes were included. DCIVA was significantly better with the VLF EDF IOL compared with the monofocal (P?0.001) and enhanced monofocal IOLs (P=0.002), while DCNVA was significantly better with the VLF FVR IOL than with all other groups (P<0.001). No significant differences were observed with with-the-rule astigmatism ?1.0 D. With oblique and against-the-rule astigmatism, differences between lens designs became more evident, with the enhanced monofocal IOL showing the highest tolerance, particularly at higher defocus levels. Across groups, ?90% of eyes tolerated 0.5 D of astigmatism with ?2 lines of Snellen loss.
Conclusion
Tolerance to residual astigmatism varies by axis and lens design. With-the-rule astigmatism was generally well tolerated, while oblique and against-the-rule astigmatism revealed clearer differences. The enhanced monofocal IOL showed the highest tolerance, supporting its clinical value when residual astigmatism is anticipated.
Presenting Author
Eric D. Donnenfeld, MD
Co-Authors
Leilei Ji (MD), Linda Tsai (MPH)
Purpose
To evaluate the quality of vision of a new purely refractive extended depth of focus IOL in comparison to a standard aspheric monofocal IOL.
Methods
This was a prospective, multicenter, randomized, subject/evaluator masked clinical study in the United States (9 sites). The 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). Visual acuity, mesopic contrast sensitivity, visual symptoms and patient satisfaction were evaluated at the 6-month postoperative visit.
Results
At 6 months, the mean binocular DCVA for the EDOF group was -0.07 LogMAR (Snellen equivalent 20/17), and for the control -0.12 LogMAR (Snellen equivalent 20/15). The mean binocular DCIVA for the EDOF group was 0.10 LogMAR (Snellen equivalent 20/25), and control 0.19 LogMAR (Snellen equivalent 20/30). The difference in mesopic contrast sensitivity between the EDOF group and the control group were 0.2 log units or less for all spatial frequencies, both with and without glare. The rates of optical/visual symptoms (halos, night glare and starbursts) for first eyes in both lens groups were generally low and comparable (?5.3% for the EDOF group and ?4.5% for control).
Conclusion
The new purely refractive EDOF demonstrated distance vision comparable to that of the monofocal control while maintaining contrast sensitivity and an optical/visual symptom profile similar to a monofocal IOL.
Presenting Author
Gal Kleinmann, MS
Co-Authors
Adi Levy (BSc, MHA), Ehud Assia (MD), Guy Kleinmann (MD)
Purpose
To report our initial experience with a new non-diffractive intraocular lens (IOL) (PureSee, Johnson & Johnson, USA).
Methods
Retrospective evaluation of 26 eyes that underwent uneventful cataract surgery with the implantation of a non-diffractive IOL. Main outcome measures at 1 month postoperatively included visual acuities at distance (UDVA), intermediate VA (UIVA), and near VA (UNVA), refractive outcome, and patient-reported outcome measures (PROMs).
Results
The study included 26 eyes from 19 patients. Thirteen men, mean age: 62.8+11.0 years (range 41-85), implanted with the PureSee IOL (JJ vision). Nineteen eyes (73%) were implanted with a toric model. Mean postoperative spherical equivalent (SE) was -0.16+0.3 D (range -0.88-[+0.50]). UDVA and UIVA were excellent (0.07+0.08 and 0.1+0.12 LogMAR, respectively), with a reasonable UNVA (0.17+0.16 LogMAR). Fourteen patients (74%) responded to the questionnaire. Spectacle independence was excellent for distance (13/14, 93%), good for intermediate (11/14, 79%), and fair for near (5/14, 36%). No patient had significant photic phenomena. Eleven patients (79%) would choose the same IOL again.
Conclusion
The PureSee IOL, a non-diffractive EDOF IOL, demonstrated excellent performance for distance and intermediate vision, with minimal photic phenomena.
Presenting Author
Nicolas Tuli, BSc, MSc
Co-Authors
Paul Harasymowycz (MD, FRCSC, MSc)
Purpose
This study aims to evaluate and compare postoperative visual acuity and contrast sensitivity outcomes of three intraocular lenses (IOLs)- AcrySof IQ Vivity, Tecnis Eyhance, and Tecnis PureSee - in patients with open-angle glaucoma who underwent phacoemulsification.
Methods
This case-control study included 72 eyes with open-angle glaucoma undergoing cataract surgery with AcrySof IQ Vivity (n=24), Tecnis Eyhance (n=24), or Tecnis PureSee (n=24) IOLs. Eyes were matched for age, sex, corneal thickness, intraocular pressure, refractive error, cataract grade, visual acuity, glaucoma medications, mean deviation, and damage on optical coherence tomography (OCT). Exclusions were other ocular pathologies affecting contrast/fields or non-emmetropia targets. Primary outcomes were best corrected visual acuity (BCVA), contrast sensitivity, and IOL-related symptoms; secondary outcomes included uncorrected visual acuity (UCVA), refractive status, and postoperative IOP.
Results
A total of 66 eyes (n=22 in each arm) have been matched. There was no statistical difference in BCVA at 6m (PureSee: 0.03+/-0.08LogMAR, Vivity: 0.02+/-0.06LogMAR, Eyhance: -0.01+/-0.08LogMAR, p=0.21) and at 40cm (PureSee: 0.29+/-0.11LogMAR, Vivity: 0.33+/-0.17LogMAR, Eyhance: 0.33+/-0.17LogMAR, p=0.64). There was a statistical difference in BCVA at 66cm (PureSee: 0.10+/-0.11LogMAR, Vivity: 0.03+/-0.12LogMAR at 66cm, Eyhance 0.14+/-0.15LogMAR, p=0.03). There was no statistical difference in photopic contrast sensitivity between the three IOLs (p=0.47 at 18 cycles per degree (cpd), p=0.45 at 12cpd, p=0.34 at 6cpd and p=0.20 at 3cpd).
Conclusion
The results indicate that all three lenses provide similar BCVA at long and short distances. Notably, Vivity may improve BCVA at intermediate distances. Finally, there was no difference in photopic contrast sensitivity between the three lenses. These findings will help guide IOL choice for cataract surgery in patients with open-angle glaucoma.
Presenting Author
Minjeong A. Koo, MD
Co-Authors
Eunchul Kim (MD, PhD), Hyun Seung Kim (MD, PhD)
Purpose
To compare the visual efficacies of three presbyopia-correcting intraocular lenses (IOLs) (enhanced monofocal: Eyhance®, extended depth of focus (EDOF): Symfony® and PureSee®).
Methods
180 eyes (90 patients; Eyhance- group 1, n= 60, diffractive type EDOF: Symfony®- group 2, n= 60, nondiffractive type EDOF: PureSee®- group 3, n= 60) who underwent cataract surgery were retrospectively enrolled. Uncorrected and corrected near (UNVA, CNVA), intermediate (UIVA, CIVA), and distant (UDVA, CDVA) visual acuity, manifest refraction spherical equivalent (MRSE), and satisfaction score were evaluated before and after surgery.
Results
The postoperative UNVA of group 2 and 3 (0.16 ± 0.11 and 0.15 ± 0.10 logMAR, respectively) was significantly better than that of groups 1 (0.34 ± 0.21) (P<0.05). Group 2 and 3 provided significantly better defocus results from -2.5 D to -3.0 D of defocus range (corresponding to 25~33 cm) compared with groups 1, respectively (P<0.05). The near vision satisfaction of group 2 and 3 (1.68 ± 1.12 and 1.59 ± 0.86, respectively) was significantly better than that of group 1 (2.24 ± 1.48) (P<0.05). The glare and halo of group 1 and 3 (1.53 ± 0.85 and 1.47 ± 0.71, respectively) were significantly lower than those of groups 2 (2.37 ± 1.26) (P<0.05).
Conclusion
The enhanced monofocal and two EDOF IOLs showed similarly good uncorrected distant and intermediate vision. The near vision with two EDOF IOLs is better than that with the enhanced monofocal IOL. The glare and halo of enhanced monofocal and non-diffractive EDOF IOLs were significantly lower than those of diffractive EDOF IOL.
Presenting Author
Hoseok Chung, MD
Co-Authors
Hun Lee (MD, PhD), Nahyun Park (MD), Myung-Sun Song (MD, MS), Jeewon Han (None), Chung Min Lee (MD), Yeaeun Lee (MD), TaeYeon Kim (MD), Taehun Kim (MD), Kyu Sang Eah (MD), Junha Kang (MBBS, BSc), Ronald Yeoh (FRCSEd, FRCOphth), Jae Yong Kim (MD, PhD), Hyeck Soo Son (MD)
Purpose
To compare postoperative visual performance between two non-diffractive, extended depth-of-focus (EDoF) intraocular lenses (IOLs) — TECNIS PureSee� and Clareon® Vivity® — by evaluating visual acuity, contrast sensitivity, and patient-reported outcomes.
Methods
In this retrospective comparative study, 102 eyes (51 per group) received either the PureSee or Vivity IOL. Visual acuity at various distances, defocus curves, and contrast sensitivity under photopic and mesopic conditions were assessed at 2 months postoperatively. Patient satisfaction and visual disturbances were also evaluated.
Results
Both the PureSee and Vivity IOL demonstrated comparable visual acuity at far and near distances, while the Vivity showing significantly better visual acuity at intermediate distances. Contrast sensitivity was significantly higher in the PureSee group at higher spatial frequencies. Patient satisfaction and spectacle independence were high and comparable in both groups. The Vivity group showed a trend toward fewer reports of glare and halo.
Conclusion
The Vivity IOL performed better at intermediate distances with fewer photic phenomena when compared with the PureSee IOL. The differences between these two EDoF IOLs may help in lens selection based on patient's visual demands and lifestyle.
Presenting Author
Gerd U. Auffarth, MD, PhD
Co-Authors
Lizaveta Chychko (MD), Lusine Vogormian (MD), Ramin Khoramnia (MD), Timur Yildirim (MD, FEBO), Alexandra Teodora Negoescu (MD), Frederick Kremser (MD)
Purpose
To evaluate the functional outcomes including visual performance and patient reported outcomes after implantation of the refractive EDOF lens Tecnis PureSee DEN00V and TECNIS PureSee Toric II (JnJ, US).
Methods
58 eyes of 29 patients who underwent phacoemulsification with implantation of Tecnis PureSee (JnJ, US) were included in this prospective study. The mean age of the patients was 71 ± 11 years. Postoperative follow-up at 3 months included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, uncorrected (UIVA) and distance corrected intermediate visual acuity (DCIVA) at 80 cm, and uncorrected (UNVA) and distance corrected near visual acuity (DCNVA) at 40 cm. Binocular best-corrected defocus curve analysis in the range +2 to -4, halo and glare simulation, contrast sensitivity under photopic and mesopic conditions were also evaluated 3 months after surgery.
Results
Mean binocular visual acuity in logMAR at 3 months follow-up was UDVA/ CDVA (-0.02/ -0.07), UIVA/ DCIVA (0.03/ 0.02) and UNVA/ DCNVA (0.16/ 0.26). Results indicate that the TECNIS Puresee IOL performs comparably to standard monofocal lenses in terms of halo/glare simulation. The contrast sensitivity under photopic and mesopic conditions is within normal age limits.
Conclusion
This study showed good visual acuity and reduced photopic phenomena. In particular, patients reported little or no photopic phenomena in terms of halo and glare simulation. The IOL power calculation for the Tecnis PureSee IOL and the implantation behaviour are uncomplicated.
Presenting Author
Samaresh Srivastava, MD
Co-Authors
Vaishali Vasavada (MS), Abhay Vasavada (MS, FRCS), Vandana Nath (MS, DO), Vijaylaxmi Meena (MS), Shail Vasavada (DNB, FRCS)
Purpose
To evaluate visual otucomes and refractive prediction accuracy following implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens (IOL) in eyes that have undergone prior laser assisted in situ keratomileusis (LASIK) for myopia
Methods
: Prospective interventional case series in eyes that have undergone myopic LASIK and scheduled for cataract surgery. A non-diffractive, wavefront shaping EDOF IOL (Vivity, Alcon Laboratories, USA) was implanted. IOL power was calculated based on the Barrett true K formula. 3 months postoperatively, unaided and corrected distance, near (40cm) and intermediate (66cm) visual acuity (UDVA, UIVA, UNVA, CDVA, CIVA, CNVA), manifest refraction and prediction error of refraction were evaluated. Three IOL calculation formulae were also compared in terms of their predictive accuracy.
Results
21 eyes (13 patients) were included. Mean age at surgery was 51.1 years. Mini-monovision was targeted in 2 patients with bilateral cataracts. 3 months postoperatively, mean UDVA was 0.15 + 0.18 (standard deviation), UIVA was 0.16 + 0.06, UNVA was 0.17 + 0.07 LogMAR units. CDVA, CIVA and CNVA were 0 LogMAR. No patient had any symptoms of dysphotopsia. Mean postoperative spherical equivalent of refraction was -0.47 + 0.5 diopters and mean prediction error was -0.34 + 0.6 diopters. 52.3% eyes were within 0.5 diopters of prediction refraction. No patient reported bothersome haloes or glare.
Conclusion
The Vivity IOL gives good unaided visual acuity with a functional range of intermediate and near vision without additional dysphotopic phenomena. There is a tendency for slight myopic outcome. This IOL provides a feasible option for presbyopia correction in post myopic LASIK eyes.
Presenting Author
Edward Tran, MD
Co-Authors
Anuradha Ondhia (OD), Iqbal Ike Ahmed (MD, FRCSC)
Purpose
To assess the quality of vision and patient satisfaction after exchanging a diffractive multifocal intraocular lens (MFIOL) for a refractive extended depth of focus intraocular lens (EDOF).
Methods
This is a retrospective, single-centre, single-surgeon cohort study (2024-2025) of bag-to-bag IOL exchanges, in which a non-tolerated multifocal IOLs, either due to positive dysphotopsias or decreased visual quality in the absence of ocular pathology, were replaced with a refractive EDOF IOL (TECNIS PureSee�). The primary outcome was patient-reported satisfaction regarding quality of vision and resolution of initial symptoms. Secondary outcomes included uncorrected and best distance visual acuity (UDVA or BCDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), manifest refraction, patient reported spectacle dependence and complications.
Results
Exchange of a non-tolerated MFIOL for an EDOF IOL demonstrated improved quality of vision, resolution of dysphotopsias, greater spectacle independence, and higher patient satisfaction. One patient, continued to experience visual disturbances. Interim analysis of eyes at ?1 month postoperatively showed no significant difference in UDVA, with mean logMAR of 0.10 ± 0.15 preoperatively and 0.07 ± 0.07 postoperatively (P = 0.33). postoperatively, with no significant difference. Mean spherical equivalent remained stable, at ?0.28 ± 0.40 D preoperatively and ?0.27 ± 0.39 D postoperatively (P = 0.93).
Conclusion
EDOF IOLs are a potential option for IOL exchange in patients intolerant of MFIOLs, as they maintain intermediate and functional near vision while improving visual quality and patient satisfaction.
Presenting Author
Oishwarya Chakraborty, MBBS, MS
Co-Authors
Rushad Shroff (MS), Apoorva Agrawal (DNB)
Purpose
To compare visual acuity at distance, intermediate & near, defocus curve in patients implanted with Hoya Impress Vs Eyhance Edof IOL
Methods
Prospective study included 30 patients planned for cataract surgery with implantation of either Hoya Impress IOLs(Group A, n=15) or Eyhance Edof IOLs (Group B, n=15). Preoperative & postoperative evaluations at 1, 3 and 6 months included measurements of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) at distance, intermediate& near with defocus curve plotting.
Results
Preliminary results indicate that both groups achieved significant improvements in UDVA and CDVA postoperatively. Group A(Hoya Impress) showed flatter defocus curve with better intermediate vision. Overall patient satisfaction was same in both groups
Conclusion
Both IOLs provide excellent visual outcomes with high patient satisfaction. Further studies with larger sample sizes & longer follow-up are recommended to confirm these findings.
Presenting Author
Oishwarya Chakraborty, MBBS, MS
Co-Authors
Rushad Shroff (MS), Apoorva Agrawal (DNB)
Purpose
To compare the visual outcomes of the PureSee� intraocular lens (IOL) and the AcrySof® IQ Vivity� IOL in patients undergoing cataract surgery.
Methods
In this prospective, comparative study, patients received either the PureSee or Vivity IOL following standard phacoemulsification. Postoperative assessments at 1 and 3 &6 months included uncorrected distance (UDVA), intermediate (UIVA), and near visual acuity (UNVA). Incidence of photic phenomena such as glare and halos was also recorded.
Results
Both groups achieved excellent UDVA with no significant differences. PureSee patients demonstrated comparatively better UNVA, while Vivity provided superior UIVA. Dysphotopsias were less frequent and less bothersome in the Vivity group. Spectacle independence was greater in the PureSee cohort for near tasks, whereas Vivity patients reported higher satisfaction with intermediate vision activities, particularly computer use
Conclusion
Both IOLs represent innovative approaches to presbyopia correction through distinct EDOF technologies. Individualized IOL selection based on lifestyle and visual priorities is recommended to maximize postoperative satisfaction.
Presenting Author
Yonca A. Akova, MD, FEBO
Co-Authors
Nilufer Yesilirmak (MD), Umut Akova (BSc)
Purpose
Extended Depth of Focus (EDOF) IOLs have been introduced as an alternative, providing a broader range of vision while limiting optical side effects. This study aimed to assess postoperative visual outcomes, spectacle independence, patient satisfaction, and the incidence of photic phenomena following implantation of the TECNIS PureSee� EDOF IOL.
Methods
Twenty-eight patients (52 eyes) undergoing cataract surgery received the TECNIS PureSee� EDOF IOL. Postoperative assessments included uncorrected and corrected visual acuity at various distances, the need for spectacles, and the presence of photic phenomena. Spectacle independence was defined by the absence of additional correction for distance, intermediate, and near vision. Patient satisfaction was also evaluated.
Results
At final follow-up, all patients achieved spectacle independence for distance and intermediate vision, with 75% attaining complete independence across all ranges. The remaining 25% required correction for near vision only at Jagger No. 1. No patients reported halos or glare. All participants reported being satisfied or very satisfied with their visual outcomes.
Conclusion
The TECNIS PureSee� EDOF IOL provided excellent visual performance with high levels of spectacle independence and patient satisfaction. Importantly, unlike multifocal IOLs, no photic disturbances were reported. The lens achieved functional vision without the need for monovision, highlighting its suitability for a wide range of patients.
Presenting Author
Benjamin Stern, MD
Co-Authors
Damien Gatinel (PhD, MD)
Purpose
To evaluate three extended-depth-of-focus intraocular lenses (EDOF IOLs) under various optical conditions using a comprehensive in vitro model.
Methods
In vitro wavefront data were acquired with a Mach-Zehnder sensor (NIMO TEMPO, Lambda-X, Belgium) to assess three EDOF IOLs: Tecnis Puresee (Johnson & Johnson), AcrySof IQ Vivity (Alcon, wavefront-shaping), and LuxSmart (Bausch & Lomb, asphericity modulation with 4th and 6th order spherical aberrations). Through-focus Modulation Transfer Function (MTF) curves (average MTF from 0 to 50 lp/mm) were generated using synthetic ISO-2 eye models across eight apertures (2-5.5 mm, 0.5 mm steps) and 21 corneal spherical aberration (SA) values (-0.49 to 0.91 ?m at 5.15 mm, in 0.07 ?m steps), totaling 168 eye model configurations.
Results
IOL profile reconstruction from wavefront acquisition shows similarity among these lenses. Vivity and Puresee demonstrated comparable optical performance across pupil sizes and corneal SA. With smaller pupils, LuxSmart showed less defocus tolerance than Vivity and Puresee but increased optical power, potentially inducing a beneficial myopic shift via the near miosis reflex. For larger pupils, Puresee and Vivity maintained high contrast in normal corneas, while LuxSmart provided better contrast in corneas with negative SA, such as those post-hyperopic or presbyopic refractive
Conclusion
This study underscores the close relationship between EDOF IOL design and patient-specific eye anatomy, such as pupil size and corneal SA, with Vivity and Puresee exhibiting similar performance, while LuxSmart demonstrates distinct optical behavior.
