Evaluation of Clareon Vivity and PureSee intraocular lenses: optical quality, depth of focus and misalignment effects

Extended depth of focus (EDoF) intraocular lenses allow cataract and refractive-lens-exchange patients to have improved vision at an intermediate distance. Two EDoF lenses, Clareon Vivity and Tecnis PureSee, were evaluated for optical quality using the OptiSpheric IOL Pro2 according to ISO 11979-2 guidelines and measured using Modulation Transfer Function (MTF) and 1951 USAF resolution test chart at 3.0- and 4.5-mm apertures. The IOLs' tolerance to 0.50 mm decentration and a 5° tilt were tested. The unwanted visual effects were compared using their light distribution at 4.5 mm aperture beyond a polychromatic point spread function center. The two models demonstrated comparable optical qualities at intermediate and far focuses; the predicted visual acuities for the Vivity and PureSee were respectively - 0.04 versus - 0.05logMAR at 0 diopter and 0.05 versus 0.07logMAR at - 1.50 diopters of defocus. Increasing pupil size decreased both lenses' optical quality. While decentration decreased the optical quality of both models, tilt had less of an effect. Both were similar in introducing minimal unwanted side effects through visualizing a halo pattern. The results indicate that these lenses offer a good option for patients interested in EDoF lenses and future clinical studies should contribute further insight into their performance and side effects.