Visual performance and coma tolerance of Clareon Vivity and TECNIS PureSee EDoF IOLs in presbyopic cataract patients

Background Cataracts and presbyopia affect millions worldwide, driving demand for advanced intraocular lenses (IOLs) to restore vision and reduce spectacle dependence. Extended depth of focus (EDoF) IOLs, such as Clareon Vivity and TECNIS PureSee, promise seamless vision with minimal disturbances, yet no study has directly compared these cutting-edge options. This research fills a critical gap by providing the first head-to-head analysis of their visual performance and optical stability in presbyopic cataract patients, offering novel insights to guide clinical practice. Methods This retrospective study analyzed 106 eyes from 72 patients over 3 months. Visual acuity (VA), defocus curve, internal higher-order aberration (HOA), contrast sensitivity (CS), and refractive error were assessed post-implantation of Clareon Vivity or TECNIS PureSee IOLs. Results Both IOLs significantly improved uncorrected distance VA (UDVA; p < 0.05). Clareon Vivity outperformed TECNIS PureSee in monocular uncorrected intermediate VA (UIVA) at 80 cm (p < 0.05) and offered a broader defocus range (+ 0.5 D to -2.0 D). Vivity also showed lower coma variability (p < 0.05), while CS and refractive outcomes were comparable. Conclusions This first direct comparison of Clareon Vivity and TECNIS PureSee EDoF IOLs demonstrates Vivity's superior intermediate vision, broader defocus range, and greater coma tolerance. These findings position Clareon Vivity as the preferred choice for presbyopic cataract patients seeking spectacle independence and high-quality vision across distances.