Hybrid Bilateral Strategy For Refractive Lensectomy: Outcomes Of Puresee/Odyssey Versus Puresee/At Lisa—A Retrospective Audit

To report early clinical and patient-reported outcomes of hybrid “mix-and-match” bilateral IOL strategies combining PureSee Partial Depth of Field–Extended, (Partial DOFi-Ex) with either AT LISA or Odyssey Full Depth of Field IOLs in refractive lens exchange and cataract patients.

Optegra Eye Health Care, UK

Retrospective audit of surgeries between January–December 2025. Two bilateral IOL cohorts were analysed:PureSee+ATLISA (n=65) and PureSee+Odyssey (n=15). Eyes with co-pathology were excluded. Toric IOLs were implanted in 59% and 57% of cases respectively. Mean patient age was 61±10 years in the PureSee+ATLISA cohort and was 60±6 years in the PureSee+Odyssey cohort. Monocular and binocular unaided distance visual acuity (UDVA) and unaided near visual acuity (UNVA) were assessed. Where binocular VA was unavailable, best monocular UDVA was used. Descriptive statistics were performed in Excel and Patient Reported Outcomes (PROMs) were evaluated using Natural Language Processing (NLP) based sentiment analysis of free text notes (Python).

Mean follow-up was 121 ± 65 days (range 7–292) for PureSee+AT LISAand  29 ± 30 days (range 7–96) for PureSee+Odyssey. % of patients achieving 20/20 or better binocular UDVA was higher in PureSee+AT LISA (91%) than PureSee+Odyssey (67%). % achieving 0.4 LogMAR or better UNVA was high in both cohorts (PureSee+AT LISA 88% vs PureSee+Odyssey 87%). PROMs analysis revealed PureSee+AT LISA showed predominantly positive sentiment (positive 67.59%, neutral 0.93%, negative 31.48%). PureSee+Odyssey demonstrated a polarised profile (positive 50.00%, neutral 0.00%, negative 50.00%). Only 6% of all respondents across both cohorts explicitly mentioned dysphotopsia within negative comments.

In this early single centre experience, the hybrid PureSee+AT LISA strategy yielded better binocular distance acuity and more favourable, less polarised patient reported sentiment than PureSee+Odyssey, while near acuity was excellent and comparable in both cohorts. Interpretation should acknowlege the smaller sample size and substantially shorter follow up in the Odyssey cohort, as well as the use of best monocular UDVA as a proxy where binocular data were unavailable. Larger, prospective studies with balanced cohorts, standardised follow up, and predefined clinical and PROMs endpoints are warranted to validate these preliminary observations and to further characterise the low rate of reported dysphotopsia.