My Results With 267 Premium IOLs

Early experience with the TECNIS Odyssey and enVista Envy IOLs.

William B. Plauché, MD

Here, I discuss my real-world data with the TECNIS Odyssey (Johnson & Johnson Vision) and enVista Envy (Bausch + Lomb) IOLs. I touch briefly on the PanOptix Trifocal (Alcon) IOLs as well.

Both the TECNIS Odyssey and enVista Envy IOLs debuted in 2024 and are categorized as full-visual-range lenses. They are advertised to decrease dysphotopsias, improve contrast sensitivity, and maintain a superior range of vision versus comparative presbyopia-correcting IOLs. If I were provided with any one of the trifocal lenses, I would be confident in their visual enhancement and correction abilities; they all feature great technology. However, there are nuances with each product where one might perform better in certain situations. The main question I attempted to answer through these data is: Do patients see better with the new full-visual-range IOLs?

I compared the 2-month UCVA data from a subset of my patients who received either the Odyssey, Envy, or PanOptix IOLs bilaterally, prior to their undergoing any enhancement or Nd:YAG laser capsulotomy (Table 1). Uncorrected visual acuity was achieved by patients within 2 months post-operatively prior to YAG laser capsulotomy or enhancement. Both the Odyssey and Envy IOLs demonstrated 20/20 UCVA in 45% of eyes. With the PanOptix lens, 20/20 UCVA was observed in 33% of eyes. Outcomes of 20/40 UCVA or worse were seen in 11% of the Odyssey eyes, 16% of the PanOptix eyes, and 9% of the Envy eyes.

I am impressed that the Odyssey lens enables patients to experience significantly improved vision at a distance with little refractive error. The enVista Envy IOL is closely matched with the Odyssey, demonstrating slightly less improvement with distance vision, though still providing great results. Patients with Odyssey lenses are particularly impressed with their improved vision and recovery on the first postoperative day, whereas patients with enVista Envy IOLs tend to need a bit longer to adjust, though they are also impressed with their improved visual progress.

Additionally, I compared each lens’ performance in the myopic range at 20/20 and 20/25 UCVA (Table 2). It’s interesting to note from the J1+ data with enVista Envy IOLs, patients had only slightly myopic outcomes (30%) compared to the Odyssey, where patients lost a bit of vision (3%). The PanOptix lens sits between the two at 16%. However, at J1, the measurements adjust to 23% with enVista Envy, 53% with PanOptix, and 13% with Odyssey.

Of the patients who achieved 20/20 UCVA at 2 months, those whose spherical equivalent was ≥ ±0.25 D were seven PanOptix recipients (25%); 12 Odyssey recipients (31.5%); and 15 enVista Envy recipients (39.5%). From this, I concluded there may be a larger landing zone with new, full-visual-range IOLs.