Visual And Clinical Outcomes Of A New Non-Diffractive Extended-Depth-Of-Focus Intraocular Lens

Extended-depth-of-focus (EDF) intraocular lenses (IOLs) have gained popularity due to their ability to extend the visual focal range, therefore providing a continuous, high-quality depth of focus. However, since their initial introduction, some patients have reported reduced contrast sensitivity and bothersome dysphotopsias. First released in Europe in February of 2024, the TECNIS PureSee IOL® (Johnson & Johnson Surgical Vision, Irvine, CA, USA) was designed to offer the visual range of typical EDF lenses, while maintaining high contrast sensitivity and a low dysphotopsia profile, comparable to monofocal lenses. Our retrospective study aims to evaluate the visual outcomes and clinical safety of this next-generation EDF lens.

This retrospective study was conducted at a refractive surgery center in Sherbrooke, Quebec, Canada.

One-hundred twenty-one eyes of 65 patients (n = 121) who underwent implantation of this EDF IOL between August 2024 and January 2025 were included in the present study. Patients were examined one day, two weeks, and six weeks post-operatively. At every visit, using the Snellen chart, uncorrected distance visual acuity (UDVA), as well as uncorrected intermediate (UIVA) and near visual acuity (UNVA) were noted in logMAR. Two and six weeks post-operatively, manifest subjective refraction was performed. Intra-operative as well as post-operative complications were analyzed.

At 1 day, 2 weeks, and 6 weeks postoperatively, mean monocular UDVA improved to 0.12 (SD 0.18), 0.03 (SD 0.12), and 0.03 (SD 0.11), respectively—with 97% and 90% of patients achieving a monocular or binocular UDVA ≤ 0 at 2 and 6 weeks. Mean monocular UIVA improved from 0.23 (SD 0.14) on day 1 to 0.08 (SD 0.11) at both 2 and 6 weeks, with 75% of patients reaching monocular or binocular UIVA ≤ 0.1 at 6 weeks. Similarly, mean monocular UNVA improved from 0.35 (SD 0.15) on day 1 to 0.21 (SD 0.12) at both 2 and 6 weeks, with 83% of patients achieving monocular or binocular UNVA ≤ 0.2 at 6 weeks. The mean absolute spherical equivalent was 0.15D at 2 weeks and 0.30D at 6 weeks. There were no intra-operative complications.

We demonstrate that the newly introduced non-diffractive EDF IOL provides a reliable range of vision and achieves acceptable outcomes for distance, intermediate, and near visual acuity. Furthermore, no intra-operative complication was observed in our study. Future studies with longer follow-up periods, the inclusion of patient-reported outcome measures (PROM) questionnaires, and larger cohorts are warranted to further establish the long-term benefits and clinical performance of this next-generation EDF lens.