As the aging patient population continues to grow, with the number of individuals between 45 and 64 in the US reaching approximately 83,750,000 in 2023,1 two conditions rank as top priorities for ophthalmologists—cataracts and presbyopia.
In addition, many members of this patient population are leading active lifestyles that compel them to seek optimal acuity while remaining spectacle-free. Advanced technology intraocular lenses (AT-IOLs) can offer a solution.
The first presbyopia-correcting IOL garnered FDA approval in 2005.2 Since then, technologies have continued to improve to address the most common patient complaints, including dysphotopsia, decreased quality of night vision, and compromised contrast sensitivity.3,4
However, until recently, these lenses fell into one of three broad categories: accommodative, multifocal, and extended depth of focus.5 In the fall of 2024, the TECNIS Odyssey IOL (Johnson & Johnson Vision) became the first full visual range (FVR) IOL to enter the market.6,7
In this article, Beeran Meghpara, MD, demonstrates implantation of this lens as well as offers his personal perspectives and pearls.
Brief overview of the TECNIS Odyssey IOL
With a diffractive surface designed to eliminate the gaps between near, intermediate, and far distances, the TECNIS Odyssey IOL is designed to improve vision at all distances for presbyopic patients while also providing good contrast in both daylight and nighttime conditions.
The IOL, which is placed in the capsular bag, currently comes in two models: DRN00V (monofocal) and DRT150-DRT375 (toric, for the correction of astigmatism).6,8
Specs for both models are as follows:8
- TECNIS IOL wavefront-designed aspheric surface
- Frosted, continuous 360° posterior square edge
- 13.0mm overall diameter
- ~1.1mm central ring diameter
- Posterior, diffractive surface (15 rings)
- 6.0mm optic diameter
- Posterior side: Haptics offset for three points of fixation
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TECNIS Odyssey IOL Surgical Video
Watch this surgical video of Dr. Meghpara implanting a TECNIS Odyssey IOL with narration.
For me, the biggest advantage of this IOL is its enhanced tolerance to residual refractive error.9 If I happen to get a result that is outside the ideal range of ±0.5D of the intended target, I find that quality of vision is less affected than it would have been with earlier-generation presbyopia-correcting IOLs.
Secondly, the TECNIS Odyssey’s freeform diffractive profile contributes to a low incidence of bothersome visual disturbances, with 93% of patients reporting no or mild glare, halo, and starburst at 1 month post-operative.10
The simulated defocus curve for this lens has a larger area under the curve (AUC) than any other presbyopia-correcting lens available in the US, which means that patients get an excellent range of vision.11
And finally, in my experience, TECNIS Odyssey offers best-in-class contrast and low-light performance by combining advanced optics with all the advantages of the TECNIS platform.
Guidelines for patient selection
As an FVR IOL with diffractive optics, the TECNIS Odyssey IOL is appropriate for cataract patients with otherwise healthy eyes. I would avoid patients with any retinal pathology or glaucoma with any visual field damage.
In addition, individuals with any corneal pathology, such as Fuchs' dystrophy, keratoconus, or epithelial basement membrane disease (EBMD), as these conditions can reduce contrast sensitivity and potentially limit visual acuity. Consistent with other presbyopia-correcting IOLs, ocular surface disease should be treated to optimize the cornea before surgery.
Pearls for success with the TECNIS Odyssey IOL
- As with any premium lens procedure, biometry and surgical technique should be meticulous.
- In selecting the IOL power, opt for the lens that will produce the predicted refractive error closest to plano or the first minus. In other words, if you have to choose between a -0.15D or +0.15D outcome, choose the lens power that will provide the -0.15D result.
- Make a uniformly round, 5.0mm capsulorrhexis.
- Remove all the viscoelastic from behind the lens. This is good practice for any toric or presbyopia-correcting lens, of course. Not only will it improve toric stability, but it will also prevent early development of posterior capsular opacification (PCO).
- When implanting the toric version of this lens, try to get it into the correct position before the haptics have fully expanded. The frosted haptics make it quite “sticky” and slightly more difficult to rotate once fully unfolded inside the eye.
In closing
Early results and patient satisfaction with this device are promising. In a 2024 open-label study conducted 1 month after implantation of the TECNIS Odyssey IOL, patients reported a 93% satisfaction rate with overall vision, with fewer reports of dysphotopsia, particularly starbursts.
In addition, 89% stated their spectacle use had reduced significantly to “none” or “little.”7 As more individuals face cataracts and presbyopia, while demanding to be spectacle-free, the ophthalmic space will be tasked with innovating technologies to meet these needs.
It is an exciting time in refractive surgery, and ophthalmologists can be certain that innovative IOLs will continue to enter the ophthalmic space to optimize vision for this ever-expanding patient population.
Disclaimer: Dr. Meghpara is a consultant for Johnson & Johnson Vision.
