Comparative analysis of visual functions following TECNIS PureSee intraocular lens implantation in patients with cataract and primary open-angle glaucoma

Abstract

Aim: to evaluate visual acuity, contrast sensitivity, and mesopic vision following implantation of the fully refractive extended depth-of-focus (EDOF) intraocular lens (IOL) TECNIS PureSee in patients with cataract and stage I–II primary open-angle glaucoma (POAG). Patients and Methods: the study included 24 patients (44 eyes) who underwent phacoemulsification with implantation of the TECNIS PureSee IOL. The study group comprised patients with stage I–II POAG (10 patients, 17 eyes), while the control group consisted of patients without glaucoma (14 patients, 27 eyes). Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were assessed for distance, intermediate, and near vision using both the decimal and logMAR scales. Contrast sensitivity and mesopic vision were also evaluated using a visual function analyzer. All examinations were performed preoperatively and 1 month after surgery. Results: one month after surgery, both groups demonstrated statistically significant improvements in visual acuity. In the study group, the median UCVA increased from 0.30 [0.20; 0.50] to 0.80 [0.70; 1.00] (p<0.001), while in the control group it improved from 0.40 [0.20; 0.56] to 1.00 [0.80; 1.00] (p<0.001). The median BCVA increased from 0.63 [0.40; 1.00] to 1.00 [0.80; 1.00] in the study group (p=0.006) and from 0.80 [0.63; 1.00] to 1.00 [0.80; 1.00] in the control group (p=0.002). No significant between-group differences were observed in the magnitude of visual acuity improvement (all p>0.05). Analysis of contrast sensitivity on the decimal scale demonstrated significant between- group differences in the change (Δ) at 40% under UCVA (p=0.008), 40% under BCVA (p=0.005), 20% under BCVA (p=0.041), 5% under UCVA (p=0.005), and 5% under BCVA (p=0.041). Mesopic vision testing demonstrated an increased proportion of patients with more favorable performance under mesopic conditions with and without glare in both groups. However, no significant between-group differences in the distribution of mesopic vision outcomes were observed either before surgery or at 1 month postoperatively. Conclusions: implantation of the fully refractive EDOF IOL TECNIS PureSee was associated with improved visual function in both patients with stage I–II POAG and those without glaucoma. These findings suggest that the TECNIS PureSee IOL may represent a promising option for intraocular lens implantation in patients with compensated POAG. Further studies with larger sample sizes and longer follow-up are needed to confirm these results. KEYWORDS: cataract, EDOF, TECNIS PureSee, glaucoma, phacoemulsification, intraocular lens, contrast sensitivity, mesopic vision, logMAR, visual acuity, binoptometry. FOR CITATION: Gorynina O.A., Fayzrakhmanov R.R., Pavlovskiy O.A. Comparative analysis of visual functions following TECNIS PureSee intraocular lens implantation in patients with cataract and primary open-angle glaucoma. Russian Journal of Clinical Ophthalmology. 2026;26(3):211–217 (in Russ.). DOI: 10.32364/2311-7729-2026-26-3-2