ESCRS 2026: Q&A: What early real-world data reveal about the TECNIS Odyssey

The TECNIS Odyssey (Johnson & Johnson) is a hydrophobic acrylic, diffractive full-depth-of-field IOL designed to provide a continuous range of vision from distance to near while limiting the photic phenomena associated with earlier diffractive designs. In this interview, Helena Noguera Nuñez, MD, Department of Refractive and Phaco-Refractive Surgery at Miranza COI Bilbao, Department of Anterior Segment and Glaucoma at Galdacano-Usansolo University Hospital, Bizkaia, Spain, discusses a prospective, observational study of 30 patients with bilateral cataracts who received either the non-toric or toric version of the lens. The study evaluated visual acuity at distance, intermediate, and near; refractive predictability; safety; and patient-reported visual quality and satisfaction over 3 months of follow-up. Below, Helena Noguera Nuñez explains how the cohort was structured, what the results showed, and where the lens fits among current options for patients seeking spectacle independence after cataract surgery.

What gap in current full-depth-of-field IOL data prompted this evaluation of the TECNIS Odyssey lens?

The rationale was to generate clinical evidence on the performance of a new hydrophobic acrylic, diffractive full-depth-of-field IOL, the TECNIS Odyssey, across the complete functional range of vision. Specifically, the study was designed not only to characterize uncorrected and corrected distance, intermediate, and near visual acuity, but also to assess refractive predictability, defocus performance, and patient-perceived visual quality. This is clinically relevant because achieving spectacle independence after cataract surgery requires more than excellent distance acuity.

A contemporary presbyopia-correcting IOL should ideally provide a continuous functional range from distance through intermediate to near, while maintaining acceptable visual quality and minimizing bothersome photic phenomena. Recent peer-reviewed clinical studies of the Odyssey similarly describe it as a continuous-range-of-vision (CRV) IOL, designed to provide useful vision across multiple distances while reducing some of the dysphotopsia associated with earlier diffractive designs.

Our study was therefore intended to assess whether this new optical platform could deliver this combination of range of vision, refractive predictability, safety, and patient satisfaction in a real-world cataract population.

How was the patient cohort selected and structured, and what distinguished the toric versus non-toric lens groups in this analysis?

This was a prospective, observational, descriptive study involving 30 otherwise healthy patients with bilateral cataracts. Surgery was performed by two experienced surgeons, and patients received either the non-toric TECNIS Odyssey DNRV000 or the toric model DRT150-375. The decision to implant the toric version was based on preoperative corneal astigmatism: the toric IOL was selected when corneal astigmatism exceeded 1.00 D.

The cohort had a mean age of 69.4 ± 7.46 years, with an equal distribution of men and women. Mean preoperative corneal astigmatism was −0.94 ± 0.62 D, and the implanted toric IOL power averaged 1.66 ± 0.45 D of cylinder. We selected the IOL power targeting the spherical equivalent closest to plano, or the first minus value.

For the visual acuity and refractive analyses, only one eye per patient—the right eye—was analyzed. This is important when interpreting the statistical results, because it avoids treating a patient’s two eyes as independent observations.

From a clinical perspective, including both non-toric and toric models is relevant because residual astigmatism can compromise the optical performance of presbyopia-correcting IOLs. Appropriate astigmatism management is therefore integral to achieving the intended full-range visual performance, rather than an ancillary refractive consideration.

How did uncorrected and corrected distance, intermediate, and near visual acuity trend between the 1-month and 3-month postoperative assessments?

The visual acuity profile was favorable across all three principal ranges—distance, intermediate, and near—and remained stable or improved between 1 and 3 months. At the monocular level, there was a statistically significant improvement in both uncorrected and corrected distance vision. Uncorrected distance visual acuity (UCDVA) improved from 0.02 ± 0.12 to −0.04 ± 0.10 logMAR (p = 0.001), while corrected distance visual acuity (CDVA) improved from −0.03 ± 0.07 to −0.08 ± 0.09 logMAR (p = 0.004). Intermediate and near acuities showed no statistically significant deterioration during the same period.

The binocular results are particularly relevant from a functional standpoint. Binocular UCDVA improved from −0.01 to −0.08 logMAR, and CDVA from −0.05 to −0.10 logMAR. In addition, both binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) improved significantly, reaching 0.00 and −0.01 logMAR, respectively, at 3 months. Intermediate acuity remained essentially unchanged.

Rather than a trade-off in which improvement at one focal range comes at the expense of another, the data show that good intermediate and near vision was maintained while distance and binocular near performance improved over the early postoperative period.

This pattern is consistent with the concept of a continuous-range-of-vision lens. Independent early clinical studies have likewise reported very good binocular vision at approximately 5–6 m, 60–66 cm, and 40 cm following bilateral Odyssey implantation.

What do the spherical equivalent and residual refraction data suggest about the predictability of this lens over the study period?

The results suggest good postoperative refractive predictability, with the mean spherical equivalent remaining relatively close to emmetropia throughout the study. The mean spherical equivalent was −0.18 ± 0.31 D at 1 month and −0.32 ± 0.33 D at 3 months. Although this represents a statistically significant shift toward mild myopia (p = 0.023), the magnitude of the change was small. Mean sphere changed from −0.12 ± 0.34 D to −0.21 ± 0.29 D, while cylinder did not change significantly (−0.13 ± 0.37 D to −0.15 ± 0.25 D; p = 0.306).

Clinically, this matters because a full-range diffractive IOL is designed to provide functional vision at multiple distances; therefore, accurate refractive targeting is important to realizing the full benefit of the optical design. The relatively small residual refractive error in our cohort is consistent with the good distance, intermediate, and near acuities observed.

Overall, our data suggest that the Odyssey provided good early refractive predictability, with no clinically meaningful refractive drift during the first 3 postoperative months.

What did the PRVSQv2 and Catquest-9SF questionnaire results reveal about how patients experienced visual disturbances such as halos or glare, and about satisfaction with everyday activities?

The patient-reported outcomes are particularly important because visual acuity alone does not fully characterize the performance of a presbyopia-correcting IOL. In our cohort, 53.33% of patients reported never experiencing halos, 30% rarely, and 16.67% sometimes; no patient reported halos often or always.

Other photic phenomena were reported less frequently: 96.67% of patients reported never experiencing glare, while 86.67% reported never experiencing either double vision or light sensitivity. No patient reported occlusions or difficulty in low-light conditions.

The Catquest-9SF findings were similarly favorable from a functional perspective: 93.33% of patients reported no difficulty with their vision in everyday life, and 86.67% were very satisfied with their current vision. More than 90% reported no difficulty with activities such as reading newspaper text, recognizing faces, seeing prices while shopping, or participating in hobbies. An important scientific nuance is that the presence of dysphotopsia is not necessarily the same as the degree to which it is bothersome.

Our findings should therefore not be interpreted as indicating an absence of dysphotopsia. Rather, they suggest that the photic phenomena reported were mostly infrequent and were accompanied by high levels of functional satisfaction and very high perceived visual quality.

Taken together, what do these safety, efficacy, and patient-reported outcomes suggest about where this lens fits among current options for patients seeking spectacle independence after cataract surgery?

Taken together, these findings position the TECNIS Odyssey as a full-depth-of-field presbyopia-correcting IOL designed to provide functional vision at distance, intermediate, and near while maintaining a favorable patient-reported visual experience. In terms of safety, there were no reported adverse events and no IOL explantations during the follow-up period.

In terms of efficacy, the lens provided good monocular and binocular visual acuity across the tested distances, with particularly strong binocular distance and near performance at 3 months. Mean refraction remained relatively close to emmetropia, supporting good early predictability.

The patient-reported data add another important dimension: most patients experienced little difficulty with everyday activities, and the reported frequency of bothersome visual disturbances was low.

From a broader scientific perspective, this is consistent with the rationale for the newer continuous-range-of-vision approach: rather than defining performance exclusively by three isolated focal points, the objective is to provide a broad and continuous functional visual range, including intermediate and near vision, while maintaining acceptable image quality and limiting dysphotopsia. Recent clinical studies of the Odyssey have reported similarly strong distance-to-near performance and high patient satisfaction.

I would therefore characterize the Odyssey not simply as another multifocal IOL but as a contemporary full-range, continuous-range-of-vision presbyopia-correcting platform for patients for whom broad spectacle independence is a priority. At the same time, the evidence base is still developing, and our 30-patient, 3-month observational study should be interpreted as supportive early clinical evidence.