J&J's Matthew Northage and Dr Dean Corbett at Auckland Eye’s Oasis Surgical clinic

In an Asia-Pacific official first, refractive surgeon Dr Dean Corbett performed a successful bilateral implant of Johnson & Johnson’s (J&J’s) new extended depth of focus (EDOF) intraocular lens (IOL) PureSee on a husband and wife at the Oasis Surgical clinic in Auckland.

The procedure was done under topical anaesthetic, so the patients were able to see straight away, said Dr Corbett. “Walking out of the practice one hour after surgery, they were both legal to drive with two lines in reserve.”

Dr Corbett, who was one of the first ophthalmologists to implant the Tecnis Symfony IOL nearly a decade ago, led a proof-of-concept study trialling the new PureSee IOL over the past 12-18 months. An extension of the popular Eyehance IOL, PureSee represents a new market entry for J&J in non-diffractive EDOF IOLs without significant dysphotopsias, said Dr Corbett.

It probably offers the greatest depth of focus of any similar product, he said. “The non-diffractive EDOF IOL technology is a market that is really growing and this is the latest IOL ‘flavour’. PureSee will add a lot in this space without any downsides, offering a greater range of vision and predictability of refractive outcome.”

Comparing PureSee to Rayner’s RayOne enhanced monovision (EMV) IOL, which was released commercially earlier this year, Dr Corbett said it’s too early to comment on which lens works better for which patient. For now, PureSee is on a limited market release until it launches commercially next year with a full range of IOLs, including toric, he said. “Lining up these two products I think it’s going to be a very close race. It's certainly nice to have two different platforms to investigate. Moving forward, it will be important to compare outcomes to help people make the best decision, in which price can be a factor as well.”

Unlike Rayner’s EMV IOL, PureSee is made of hydrophobic material which Dr Corbett said he believes surgeons will feel more comfortable with, given that it’s the currently accepted standard. Still, he said, hydrophilic materials have improved a lot, though there’s certainly still some debate about their pros and cons.

Given how rapidly the landscape of lens replacement is evolving, the more optometrists can do to engage their patient in education about lens options and visual requirements the better, said Dr Corbett. “What we used to call cataract surgery is a completely different beast nowadays. It’s lens replacement to enable better vision and interaction with the environment. It’s no longer a single event, it’s a process which includes enhancement of post-operative refractive errors, maintenance of health of the ocular surface and the visual media, including the vitreous. All these things must be considered to deliver an optimal outcome.”