Visual Performance Of Clareon® Vivity® And Puresee® Intraocular Lenses In Patients Undergoing Cataract Surgery

Partial-range of field-extended intraocular lenses (PRoF-Ex IOL) are increasingly implanted in developed countries because they provide very good distance and intermediate visual acuities (VA) with induction of minimal dysphotopsia. However, head-to-head comparisons between these IOL are uncommon, limiting the assessment of their relative advantages and limitations. We evaluated the performance of two PRoF-Ex IOL, the Clareon Vivity (Alcon Healthcare, US) and PureSee (Johnson & Johnson, US) lenses.

The study was conducted from June 2025 to February 2026 in OMIQ Research facilities, a private ophthalmology research group in Barcelona, Spain.

Prospective, randomized, patient and VA examiner-masked, clinical trial comparing the Clareon Vivity and PureSee PRoF-Ex IOL. Patients ≥50 years-old with age-related cataracts and no other ocular comorbidities were randomly assigned to one group in a 1:1 ratio. The main endpoint was the binocular distance-corrected intermediate VA at 66 cm (DCIVA) at month 3. Other endpoints included the spherical equivalent (SE), mono/binocular, distance-corrected and uncorrected VA at far, intermediate and near; defocus curve (DC); and spectacle independence and symptoms of dysphotopsia via the IOLSAT and QUVID questionnaires. Data were compared with independent Student’s-t/Mann-Whitney tests according to their distribution or Fisher’s exact test.

We included 80 patients (40 per group), with no drop-outs at month 3. There were no imbalances in baseline characteristics except for astigmatism, which was 0.27 larger in the PureSee group (p=0.004). The mean SE was -0.15D (SD 0.25D) for Clareon and 0.00D (SD 0.25D) for PureSee (p=0.0002). The binocular DCIVA was 0.06 logMAR (IQR 0.11, Clareon) vs 0.12 (0.08, PureSee), p=0.06. The monocular DCIVA was 0.12 logMAR (IQR 0.11, Clareon) vs 0.18 (IQR 0.10, PureSee), p=0.0025. The DC at +1D favored the PureSee (0.18 vs 0.22 logMAR, p=0.06), while at -1D and -2D favored the Clareon (0.08 vs 0.11 [p=0.06] and 0.25 vs 0.29 logMAR [p=0.05]). More than 70% of patients reported total absence of dysphotopsia, with no differences between IOL (p≥0.25).

Clareon Vivity and PureSee IOL provide excellent performance at distance and intermediate distances, with functional vision at near. There was generally high patient satisfaction with few symptoms of dysphotopsia with either IOL. The performance of Clareon Vivity was numerically superior to that of the PureSee IOL at intermediate and near distances, but with borderline statistically significant results.