ESCRS 2026: Diffractive multifocal IOLs match at distance but diverge sharply on mesopic reading speed

At the 2026 Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), held 11–15 September in London, Jascha Wendelstein, MD, presented expanded findings from his group's study comparing reading speed and visual acuity outcomes across three diffractive multifocal intraocular lenses (IOLs)—the AT LISA tri (Carl Zeiss Meditec), the TECNIS Synergy (Johnson & Johnson Vision), and, newly added to the analysis, the TECNIS Odyssey (Johnson & Johnson Vision). Wendelstein is a cataract and refractive surgeon at the IROC Institute in Zurich, Switzerland. The original 2-lens comparison was published in the American Journal of Ophthalmology (AJO) in 2026.

Comparable at distance, divergent up close

According to Wendelstein, distance-corrected visual acuity was similar across all three lens models. The meaningful differences emerged only once the analysis moved to reading speed under different lighting conditions.

A steep photopic-to-mesopic drop

Across all three lenses, reading speed fell sharply between photopic and mesopic conditions—from approximately 130 to 140 words per minute in photopic light down to around 30 words per minute under mesopic conditions. Wendelstein noted that a reading speed of roughly 80 words per minute is generally considered the threshold for satisfying reading, meaning every lens tested fell below that mark in mesopic light.

Focus curve differences tied to laser vision correction

Focus curve analysis showed the Synergy lens had a narrower slope that dropped off faster approaching intermediate acuity and extended further into near acuity, whilst the other lenses maintained a higher peak at distance acuity. Wendelstein linked this pattern directly to clinical outcomes: the Synergy lens required a higher rate of secondary laser vision correction to reach patient satisfaction compared with the other lenses in the study.

Clinical takeaway

Wendelstein's takeaway for lens selection is to prioritise strong performance at the correct working distance and a good near-distance balance, rather than maximising near vision at the expense of the distance peak. He also pointed to how patient expectations shape secondary laser vision correction rates: at his current practice in Zurich, rates run higher than at his previous, smaller practice in Austria, where he said patients had different expectations of multifocal lens outcomes. With the AT LISA tri, he added, the laser vision correction rate has come down.