PureSee IOL - the great advantage uncovered

The EDOF segment has been created in 2014 by the Symfony lens, which is well known to you. It had a diffractive echelette design and was sometimes mistakenly seen as a multifocal lens. But it isn’t — we’ve talked a lot about this. It’s an EDOF lens, just based on diffractive technology. Then, the era of non-diffractive technology began in 2019 — also by Johnson & Johnson — with the Tecnis Eyhance. But I want to note: Eyhance is not an EDOF lens in the sense of criteria defined by the American Academy of Ophthalmology or ESCRS. It’s an enhanced monofocal lens, though the internal technology is an EDOF based. The first true non-diffractive EDOF lens was Alcon’s Vivity, well known since 2020, with its X-Wave technology — well visible in the central optics its core element which refracts the light into a single elongated focal point.

Then in 2024 J&J released Tecnis PureSee, a fully refractive lens using completely different technology, with no visible optical elements. We’ll discuss it details shortly.

And now, let's focus on what is important if we are talking about presbyopia-correcting lenses.

Here we should focus on three key components: first — the defocus curve; second — positive dysphotopsia or night halo effects; third — possibly the most underestimated yet most critical for functional vision — the contrast sensitivity.

When we talk about losing details with a lens, we imagine a slightly lower-quality image as I said. And we think “It’s not good, but it's okay to live with it, nothing special”

But no — it’s about unrealistic images, where parts of the image or entire low contrast objects in the shadows may dissapper, like pedestian on a dark road. This is the problem.

And how do we avoid it? By using an IOLs which keeps as much of contrast as possible and that's why transmit more contrast-rich images to improve patient contrast sensitivity and needed details.

Today we have such a lens — Tecnis PureSee — a new fully refractive presbyopia correcting IOL from JnJ, available in the world since 2024, and hopefully to be available in US in 2025 (I have no data, but that's my expectations)

So, let's uncover what is known to us about the PureSee.

Defocus curve: identical to the well-known Symfony, and we already have a lot of clinical experience with both Symfony and PureSee. Some of your colleagues who’ve used PureSee say that it works at least as good as Symfony and sometimes even better.

Another critical factor related to defocus curve is a tolerance to refractive errors, especially important for complicated eyes — hyperopes, high myopes — but really for everyone.

Have a look at the interesting comparison. Look at Eyhance vs PureSee. That lower zone is larger for PureSee — these are patients who got uncorrected 1.0 distance acuity. It’s larger for PureSee. The second, darker zone is 0.8 to 1.0 acuity — smaller for PureSee. So PureSee gives you more safety.

Next — the magic explained by physics. PureSee has no distinct optical zones, so there’s nothing to distort light sources. As said yesterday — virtually zero patient complaints of night dysphotopsia. That’s very important. 

Contrast sensitivity — again, crucial. In PureSee, contrast sensitivity is comparable and almost identical — to Eyhance. But, let’s recall what Eyhance gives in terms of optics. We said “everything is fine,” but let’s compare, maybe Eyhance isn’t as perfect as we think.

Here’s official optical bench testing data from JNJ — publicly available. They tested various lenses. Eyhance has slightly lower MTF than the basic Tecnis monofocal, but in wide pupils and low-light conditions, it performs 31% better than standard monofocal lenses, including Alcon Clareon. That means better contrast sensitivity potential overall.

What about PureSee? Same test — optical comparison with similar lenses. Big difference here — PureSee vs Vivity — especially 36% better in low light. Again, it’s about giving patients more contrast, better visual quality — simply better vision.

Next — this part is personal. I'm planing a refractive lens exchange due to my high hyperopia.

And I want to compare two worlds — which I believe no one has yet done. I compare MTF on the same scale for monofocals vs EDOFs — Eyhance, PureSee, Vivity and monofocal Clareon. And look at this magic. In low-light, where all compromises of presbyopia correcting IOLS are well noticeable, with a 5 mm pupil, monofocal Clareon performs slightly worse than presbyopic PureSee. That’s amazing.

If you are interested in detailed Eyhance IOL review - it's available by the link at IOL-adviser YouTube channel. Also, Alcon Clareon review is available by the link.

And finally - Alcon Vivity IOL review as well on my YouTube.

So what does all this mean?

It means we’ve finally reached the point where a lens designed to correct presbyopia — without diffractive optics — can offer not just functional range, but excellent night vision, minimal dysphotopsia, and contrast sensitivity comparable to or even exceeding some monofocals.

And that’s why, as a patient and an expert, I’m seriously considering PureSee for my own eyes. Because now, for the first time, I see a lens that truly aligns with my needs — sharp, contrast-rich, low-glare vision across distances, even in low light. And that’s the kind of vision I want to live with for the rest of my life.

Oleksii at IOL-adviser.com