Real-World Outcomes Of Tecnis Puresee™ Edof Iol In Mild Ectasia-Suspect Eyes: Uncorrected Distance, Intermediate And Near Acuity With Dysphotopsia Severity And Bothersomeness

To evaluate uncorrected distance, intermediate and near visual acuity and patient-reported dysphotopsia (type, severity and bothersomeness) after TECNIS PureSee™ EDOF intraocular lens implantation in eyes with ectasia-suspect (mild forme-fruste keratoconus) features.

Retrospective chart review at a tertiary cataract and refractive surgery practice in Calgary, Alberta, Canada.

Retrospective chart review of adults implanted with TECNIS PureSee™ (toric or non-toric). Patients were classified as ectasia-suspect if keratoconus/forme fruste/ectasia features were documented in either eye. Outcomes were extracted from postoperative visit at postoperative day 28 or later. Monocular uncorrected distance (UCDVA), intermediate (UCIVA) and near (UCNVA) visual acuity were recorded. Dysphotopsia severity and bothersomeness for halos, glare and starburst were assessed. “Bothersome dysphotopsia” was defined as moderate-to-severe bothersomeness. Visual acuity outcomes are reported per eye; dysphotopsia outcomes per patient. Follow-up completeness is reported. Outcomes are descriptive (proportions meeting Snellen thresholds).

Eleven patients (21 eyes) were included (mean age 69.4±4.8 years; 45.5% male). Toric TECNIS PureSee™ IOL was implanted in 16/21 eyes (76.2%). At postoperative day 28 or later, UCDVA was available in 20/21 eyes: 19/20 (95.0%) achieved ≥20/40, 13/20 (65.0%) ≥20/25 and 10/20 (50.0%) ≥20/20. UCIVA and UCNVA were available in 13/21 eyes each: UCIVA 12/13 (92.3%) achieved ≥20/40 and 6/13 (46.2%) ≥20/25; UCNVA 10/13 (76.9%) achieved ≥20/40 and 3/13 (23.1%) ≥20/25. Dysphotopsia assessment was available in 11/11 patients; no patient reported halos, glare or starbursts.

In mild ectasia-suspect eyes, TECNIS PureSee™ IOL achieved functional uncorrected distance and intermediate vision at 1-month with no reported dysphotopsia or bothersomeness; however, near/intermediate endpoint completeness was limited and should be considered when interpreting outcomes. Larger prospective studies with standardised follow-up are warranted to confirm performance in eyes with irregular corneas.