Refractive Predictability, Visual Rehabilitation And Dysphotopsia Profile Of The “Tecnis Odyssey” Iol Following Clear Lens Exchange And Cataract Surgery: A Retrospective Analysis Of 177 Eyes

To evaluate refractive predictability, visual rehabilitation, safety, and subjective visual quality following implantation of the “Tecnis Odyssey” IOL (Johnson&Johnson Vision, USA) in clear lens exchange (CLE) and cataract surgery. Primary endpoints included uncorrected (UDVA) and corrected distance visual acuity (CDVA), refractive accuracy relative to target refraction, safety index, and patient-reported dysphotopsia profile at 12 weeks postoperatively, with focus on spectacle independence and functional visual performance.

Retrospective single-center study of 177 consecutive eyes operated by one surgeon. 113 eyes underwent CLE and 64 cataract surgery. In 172/177 eyes, femtosecond laser-assisted surgery was performed using the Ally system (LensAR, Orlando, USA). Limbal relaxing incisions were applied to correct pre-existing corneal astigmatism. Toric Odysseys were chosen above 0,8 dpt of astigmatism in the delta total corneal astigmatism value provided by the IOL Master 700 (Zeiss Meditec, Jena,Germany).

Preoperative assessment comprised manifest refraction, spherical equivalent (SE), UDVA and CDVA (logMAR). Optical biometry was performed using IOLMaster 700. IOL power calculation was supported by the ESCRS IOL Calculator and the calculation service of Johnson & Johnson. Target refraction for refractive accuracy analysis was defined using the Kane formula. Postoperative follow-up at day 1, week 1, and 12 weeks included UDVA at each visit and full manifest refraction and CDVA at 12 weeks. Subjective visual quality, patient satisfaction, and dysphotopsia profile (halo and glare phenomena) were systematically evaluated.

At 12 weeks, mean UDVA improved from 0.17 to 0.05 logMAR (CLE: 0.04; cataract: 0.07). Cataract eyes demonstrated slightly delayed early visual rehabilitation at day 1 and week 1 when compared to the CLE group, whereas final outcomes were comparable between both cohorts. Refractive predictability was high: 63% of eyes were within ±0.25 D, 87% within ±0.50 D, and 94% within ±0.75 D of target refraction; 2.8% exceeded ±1.0 D. Prediction error was centered near emmetropia with low dispersion. Subjective visual quality was rated high. Photic phenomena were predominantly mild; no patient reported severe halo-related functional impairment. A neuroadaptation process was observed, no IOL explantation was required. The safety index exceeded 1.0.

The Odyssey IOL demonstrated excellent refractive predictability, high subjective visual quality, and reliable safety in both CLE and cataract eyes. Although early visual rehabilitation was slightly slower in cataract eyes, 12-week functional outcomes were equivalent. The high proportion of eyes within ±0.50 D confirms very convincing biometric precision. The dysphotopsia profile was favorable, with predominantly mild photic phenomena and clear evidence of resolution due to neuroadaptation.

The Tecnis Odyssey IOL enables a high degree of spectacle independence, robustness to minor residual refractive error while inducing only minimal glare and halo burden in routine refractive lens surgery as well as in patients undergoing cataract surgery.