Glistening-Free Multifocal IOL Delivers Satisfaction

A multifocal presbyopia-correcting intraocular lens (IOL) made of a new, glistening-free hydrophobic acrylic material and available in both aspheric and toric aspheric versions provided good visual acuity at all distances in recent studies. It also delivered high patient satisfaction and spectacle independence and good contrast sensitivity, according to Thomas Kohnen MD, PhD.

Moreover, though nearly three-quarters of patients reported experiencing optical phenomena such as glare and halos, they were not troubling, he added.

The trifocal aspheric Clareon PanOptix and toric aspheric Clareon PanOptix IOLs (Alcon) build on the legacy of the PanOptix multifocal lens—first implanted by Professor Kohnen in July 2015 in Frankfurt, Germany. The new Clareon material is free of glistenings, enhancing lens clarity by reducing light scatter and surface haze. Clareon lenses also feature a proprietary edge design to reduce optical phenomena.

Visual acuity results

In a prospective, single-site study of 27 patients implanted bilaterally with aspheric or toric aspheric Clareon PanOptix IOLs, visual acuity results were good, Prof Kohnen reported. At the 12-month follow-up, mean monocular visual acuity at distance measured 0.01±0.12 logMAR uncorrected and -0.03±0.10 corrected. Intermediate at 80 cm measured 0.02±0.10 uncorrected and 0.03±0.09 distance corrected, and at 60 cm 0.00±0.10 uncorrected and 0.00±0.09 distance corrected. Near vision at 40 cm came in at 0.08±0.11 uncorrected and 0.07±0.09 distance corrected.

About one-third of eyes reached a visual acuity of -0.10 or better at distance and at 40 cm intermediate, uncorrected. Defocus curves for the new material lenses were similar to those observed for the previous, non-Clareon PanOptix lenses, peaking at about -0.02 for distance at 0.00 D defocus compared with -0.05 for the earlier lens, and again around 0.05 at an intermediate defocus of -1.50 D compared with -0.01 for the earlier lens.¹

Contrast sensitivity of the new lenses proved slightly better than the previous material PanOptix lenses and slightly worse than an Alcon standard SN60WF monofocal lens, Prof Kohnen observed.^1–2

Patient-reported outcomes

More than 90% of patients reported spectacle independence, with 2 patients reporting a need for glasses at intermediate distance. Halos were observed by 67%, glare by 33%, starbursts by 7%, and distorted vision by 4%. No patients reported ghosting or double vision.

“We still have halos; it is a trifocal design,” Prof Kohnen said. However, halos, as seen by a visual simulation of mean results, diminished between 3 months and 6 months after surgery, suggesting visual habituation to the phenomena over time.

So, in addition to good vision, patient satisfaction, and contrast sensitivity, “72% perceive optic phenomena but are not disturbed by them,” Prof Kohnen concluded.

Prof Kohnen spoke at the 2025 ASCRS annual meeting in Los Angeles.

Thomas Kohnen MD, PhD, FEBO is professor and chair, Department of Ophthalmology, Goethe University, Frankfurt, Germany. He is also past ESCRS treasurer and co-editor of the Journal of Cataract & Refractive Surgery. kohnen@em.uni-frankfurt.de

1. Kohnen T, et al. Am J Ophthalmol, 2017; 184: 52–62.

2. Kohnen T, et al. Ophthalmology, 2009; 116: 1697–706.