New research out of the 2025 annual meeting of the Association for Cataract and Refractive Surgeons (ASCRS) includes clinical findings following the implantation of Johnson & Johnson Vision’s Tecnis Symfony OptiBlue intraocular lens (IOL) in glaucoma patients.
Let’s begin with this lens.
First introduced in September 2022, the Tecnis Symfony OptiBlue IOL is an extended-depth of focus (EDOF) and presbyopia-correcting (PC) IOL (and is also available in toric II).
Key to its capabilities: JJV’s proprietary InteliLight Technology, which features a violet-light filter that protects the eye against the shortest wavelengths of light.
- What that does: This mitigates glare and halos (often experienced by cataract and presbyopia patients) to:
- Optimize image contrast across varying distances
- Reduce light scattering to boost clarity during digital device usage (via an echelette design)
- Enhance vision at night and in low-light conditions (reducing contrast sensitivity [CS] concerns])
- Plus: Achromatic technology is designed to correct chromatic aberration for better visual contrast sensitivity during day and night.
So which target patients might benefit from this lens?
Aside from the obvious—presbyopes—the EODF lens’ ability to filter violet light, minimize dysphotopsia, and reduce CS concerns makes it ideal for implantation into another patient base:
- Glaucomatous patients seeking an extended range of vision after cataract surgery
Now let’s get to this new research.
In this ambispective, noncomparative, observational study, investigators sought to identify clinical and patient-reported outcomes following the bilateral implantation of the Tecnis Symfony OptiBlue IOL in patients diagnosed as either glaucoma suspect or with mild glaucoma.
The setup:
- Participants: 25 patients (aged 40+) with cataracts and either suspected or mild glaucoma
- The design: All patients were implanted with the violet light-filtering IOL (including its toric option)
- The refractive targets:
- Plano target in the dominant eye
- 0.5 diopter (D) mini-monovision target in the nondominant eye
- The refractive targets:
To note: Patients were excluded if they had significant visual field (VF) defect or defects within 5° of fixation; optic nerve head damage; a pre-existing retinal disease; or intraoperative complications.
And what was measured?
Three main outcomes:
- Uncorrected visual acuities (monocular and binocular)
- Change in IOP from baseline
- Patient-reported outcomes
Also, take note for context: The following distances apply for these three vision categories:
- Distance vision = more than 5 feet away
- Intermediate vision = 1.5 to 5 feet away
- Near vision = less than 1.5 feet away
Got it. Next up: the findings.
Keep in mind: The following data were reported seven days following IOL implantation.
We’ll begin with those uncorrected visual acuities (VAs):
- Monocular
- Mean uncorrected distance and intermediate VA (UDVA; UIVA, respectively) was an estimated 20/22
- UDVA = 0.06 logMAR
- UIVA = 0.04 logMAR
- Mean uncorrected near VA (UNVA) was approximately 20/26
- UNVA = 0.12 logMAR
- Mean uncorrected distance and intermediate VA (UDVA; UIVA, respectively) was an estimated 20/22
In all: Over 91% of all participants demonstrated VA of 20/30 or better for all three vision types (distance, intermediate, and near)
- Binocular
- Mean UDVA and UIVA was 20/20
- Mean UNVA was 20/23
In all: All patient eyes (100%) achieved UDVA, UIVA, and UNVA of 20/30 or better following implantation.
Nice! How did refractive outcomes fare?
The postop mean refractive spherical equivalent (MRSE) was found to be slightly myopic (-0.29 ± 0.42).
- The numbers: 72.9% and 89.6% of eyes achieved within 0.5 D and 0.75 D (respectively)
And IOP?
Investigators observed that, as expected, the mean IOP was reduced following cataract surgery.
- The numbers: 17.3 mmHg (preop) to 13.6 mmHg (postop)
How many patients experienced dysphotopsia symptoms postop?
Around 25% of all patients—and mainly at night.
Among these symptoms: halos, starbursts, light sensitivity, glare related to light scatter, and poor low vision.
Importantly: Investigators noted that “about 80% or more of patients said [they] were not bothered much by dysphotopsia or other visual symptoms.”
What else to know?
The percentage of patients reporting spectacle independence—as in, not requiring their glasses—was as follows for the three VA categories:
- Distance = 95%
- Intermediate = 98%
- Near = 65%
And their overall vision satisfaction, post-implantation?
Nearly all—90% to 95%—patients reported being “mostly or completely satisfied” with their distance and intermediate vision.
Meanwhile, almost three-fourths (70%) noted they were “completely/mostly satisfied” with their near vision without the use of glasses.
So, all in all, what did the study authors conclude?
The main takeaway: Violet-light filtering IOLs such as the Tecnis Symfony OptiBlue IOL can provide mild glaucoma (and suspect glaucoma) patients with “good vision at all distances.”
However: They added that research should be continued on all EDOF IOL platforms in order to give glaucoma patients improved options for cataract surgery.
That’s great to hear! And how can I learn more about this data?
If you’re attending ASCRS, check out the presentation of these findings:
- Title: Clinical Outcomes in Patients with Mild Glaucoma Following Implantation of Violet Light-Filtering, Extended Depth of Focus IOLs
- Presenting author: Zarmeena Vendal, MD
When: Saturday, April 26 (see here for timing and location)