ESCRS 2026: Real-world enVista Envy outcomes match clinical trial results, even with residual refractive error

At the 44th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), held September 11–15, 2026, in London, Adam Muzychuk, MD, BSc, FRCSC, of the University of Calgary, presented real-world outcomes from 2 studies of the enVista Envy (Bausch + Lomb) full range of vision intraocular lens (IOL).

Visual performance in routine clinical practice

The first study evaluated outcomes across 14 sites in the United States and Canada, covering more than 160 eyes implanted with the full range, non-toric IOL. Muzychuk reported that 90% of patients reached a binocular uncorrected distance visual acuity of 20/25 or better. Binocular uncorrected intermediate visual acuity reached 20/25 or better in 96% of eyes, and 92% of eyes achieved binocular uncorrected near visual acuity of J2 or better. Rates of dysphotopsia—glare, halos, and starbursts—each affected 5% or fewer of patients. “This was in keeping with what we saw in the clinical trials,” Muzychuk said.

Impact of residual refractive error

A second, multicentre, retrospective analysis of 166 eyes examined how residual refractive error affects visual outcomes with the enVista Envy. Muzychuk reported that 70% or more of patients with up to 1 dioptre of residual cylinder achieved 20/25 or better, and that patients who were targeted for, and achieved, plano had the best outcomes across distance, intermediate, and near vision. “No surgeon is perfect, and we don’t have to be,” Muzychuk said. “This represents what patients are going to achieve in the real world, and even if we’re not perfect, they’re still going to be happy.”

Formula selection and clinical takeaways

Muzychuk recommended modern IOL power calculation formulas, such as EVO or Kane, over formulas such as Barrett, citing the precision needed to stay within a quarter dioptre. He advised surgeons to target as close to plano as possible, even when that means a slightly hyperopic result—an approach he acknowledged “may not feel natural” to surgeons accustomed to targeting first minus. Muzychuk also encouraged surgeons who have been disenchanted with multifocal lenses to reconsider, adding, “If you’re not using multifocal, you’re probably doing your patients a disservice.”