Enhancement Rates Across Full Range Of Focus Iol Platforms

To compare the incidence and type of complementary treatments following implantation of four full-range-of-focus intraocular lenses (IOLs): Tecnis Synergy™, Tecnis Odyssey™, AT LISA, and AcrySof PanOptix.

The primary outcome was the enhancement rate related to residual refractive error.

Secondary analyses evaluated the influence of IOL combinations (bilateral, unilateral, Mix & Match), prior laser vision correction (LVC), toric versus spherical IOLs, and residual spherical equivalent (SEQ)

Retrospective multicentre cohort study conducted at three specialized FYEO refractive surgical centers. All refractive lens exchange (RLE) procedures were performed between November 1, 2024, and November 1, 2025, by 21 experienced refractive surgeons, using standardized protocols, identical surgical equipment, and IOL calculations based on Barrett True-K.

Follow-up was 3 months postoperatively.

Complementary treatments were included within the RLE treatment package.

A total of 5,966 clients (10,299 eyes) aged >40 years undergoing RLE with full range-of-focus IOLs were included. Enhancement was defined as any additional intervention (e.g., LVC, IOL exchange, add-on lens) performed due to clinically relevant residual refractive error or visual dissatisfaction.

Enhancement rates were compared between IOL platforms and subgroups (SEQ ≥0.50 D vs <0.50 D, prior LVC, bilateral vs Mix & Match, toric vs non-toric).

Statistical comparisons tested differences between lens models (H₀: no difference).

Overall enhancement rates differed significantly across IOLs (p < 0.001). Tecnis Synergy™ showed the highest rate (8.12%), followed by PanOptix (5.71%) and AT LISA (4.19%), while Tecnis Odyssey™ demonstrated the lowest rate (1.78%).

Prior LVC markedly increased the enhancement risk for all IOLs.

Residual SEQ ≥0.50 D was associated with higher enhancement rates. Despite a higher proportion of post-LVC eyes, Odyssey™ maintained the lowest enhancement incidence.

Enhancement rates after RLE with full range-of-focus IOLs vary significantly between lens platforms. Tecnis Odyssey™ demonstrated a consistently lower need for complementary treatment, even in a more complex population with previous LVC. Tecnis Synergy™ showed the highest enhancement rate, confirming greater sensitivity to residual refractive error. These findings may guide IOL selection and patient counselling to minimize postoperative interventions and optimize refractive outcomes.