Refractive EDOF with the Benefits of Monofocal

Poor night vision outcomes and reduction in contrast sensitivity are among the greatest concerns regarding the implantation of presbyopia-correcting IOLs. First highlighted by an ESCRS survey, this issue has recently been valued more by the industry and has received more consideration for the common photic phenomena associated with PCIOLs like halo, glare, and starbursts. For this reason, designs for the next generation of EDOF IOLs aim to address these vision quality issues, according to José Manuel Díez del Corral MD.

Dr del Corral discussed the results from two recent studies investigating the quality and depth of vision of Johnson & Johnson’s TECNIS PureSee IOL, a purely refractive EDOF lens with an anterior surface that is the same as any monofocal-plus IOL. The posterior surface instead includes a continuous and smooth change in the profile, without rings or separated optical zones. With these changes, it maintains a dysphotopsia profile comparable to that of a monofocal lens, enabling a consistent and extended depth of focus from distance to near.

The first study was a prospective, randomised, two-way masked trial of 60 patients bilaterally implanted with either TECNIS PureSee IOL or a monofocal-plus Eyhance IOL. This study took place in six sites in Australia and New Zealand. The second study was a post-market prospective study on 38 patients with bilateral TECNIS PureSee implants, conducted in three sites in Europe and still ongoing.

Results from the first study showed that at least 50% of eyes obtained an intermediate visual acuity within 0.2 logMAR. The PureSee IOL also had 0.7 D more range of vision at 0.2 logMAR than the monofocal counterpart and non-inferiority in the distance vision.

In the second study, uncorrected and corrected binocular visual acuity (UCDVA and BCDVA) were excellent results at all distances (-0.09 distance, 0.08 intermediate, and 0.20 logMAR near uncorrected and 0.13 distance, 0.08, and 0.17 logMAR distance-corrected VA). Monocular UCDVA was 0.01±0.09 logMAR and BCDVA was 0.08±0.07 logMAR. The lens provides over 2.5 D of continuous range of vision, binocularly at 0.2 logMAR or better, which is a very nice range of focus, he added. Most patients achieved visual acuity of 0.2 logMAR or better, not only for distance or intermediate, but also for near vision.

Regarding the quality of vision, almost every patient was happy except for a few who experienced some dysphotopsia. In addition, both studies showed similar degrees of contrast sensitivity and low light performance with the comparison monofocal lens.

The results of the studies showed a high quality of vision at all distances, dysphotopsia, and contrast sensitivity compared to a monofocal IOL and an overall satisfaction of 89%, with almost every patient recommending it to family and friends, Dr del Corral concluded.

Dr Díez del Corral presented at the 2024 ESCRS Congress in Barcelona.

José Manuel Díez del Corral Belda MD is Medical Director at the Clínica Oftalmológica Díez del Corral, Madrid, Spain, and Medical Advisor EMEA Johnson & Johnson Vision. jmddcb@yahoo.es