Comparative Visual Performance and Optical Stability of Clareon Vivity and TECNIS PureSee EDoF IOLs in Cataract Patients

Purpose: Cataracts and presbyopia affect millions worldwide, driving demand for advanced intraocular lenses (IOLs) to restore vision and reduce spectacle dependence. Extended depth of focus (EDoF) IOLs, such as Clareon Vivity and TECNIS PureSee, provide continuous vision with minimal disturbances. Given limited direct clinical comparisons, this research offers a head-to-head analysis of their visual performance and optical stability in cataract patients. Patients and Methods: This retrospective cohort study analyzed 106 eyes from 72 patients who underwent phacoemulsification with Clareon Vivity or TECNIS PureSee IOL implantation. Primary outcome measures were monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected intermediate VA (UIVA) at 66/80 cm, uncorrected near VA (UNVA) at 40 cm, and longitudinal internal higher-order aberrations (HOAs), specifically total coma. Refractive error (spherical/cylindrical powers [SPH/CYL], spherical equivalent [SE]) and defocus curve (+1.5 D to – 3.5 D under mesopic/photopic conditions) were measured at 1 and 3 months postoperatively; HOAs (spherical aberration [SA], coma) and pupil size were assessed at 1 week, 1 month, and 3 months, and contrast sensitivity (CS; 1.5– 18 cpd) at 1 month using standardized equipment. Results: Both IOLs significantly improved UDVA (p < 0.05). Clareon Vivity showed superior monocular UIVA at 80 cm at 1 and 3 months (p = 0.0042 and p = 0.0711, respectively), comparable UIVA at 66 cm and UNVA at 40 cm, a broader defocus range (+0.5 D to – 2.0 D), and lower total coma at 1 and 3 months (p = 0.001 and p = 0.0097) with reduced variability, emphasizing mid-range vision and optical stability advantages. TECNIS PureSee exhibited comparable refractive outcomes and CS, with initial superiority in monocular UNVA at 40 cm at 1 month (p < 0.05), providing robust early near vision. Conclusion: Clareon Vivity excels in intermediate vision, defocus tolerance, and coma stability, while TECNIS PureSee offers strong initial near focus. These differences suggest Clareon Vivity may be particularly suitable for patients prioritizing mid-range stability, while both IOLs provide excellent overall visual performance. Keywords: EDoF IOLs, cataract surgery, visual performance, coma tolerance