Why innovation matters in a crowded PCIOL landscape

In today’s crowded presbyopia-correcting intraocular lens (PCIOL) landscape, surgeons face a growing range of optical technologies, materials, and designs to choose from. These advancements have expanded what is possible for patients, while raising expectations for predictability, image quality, and overall satisfaction.

Given the PCIOL “boom”, surgeons are increasingly considering not just visual acuity results and image quality, but also consistency from patient to patient, tolerance to variability, patient satisfaction with low level of dysphotopsia and simplification in postoperative management.

To address this situation, Alcon, the global leader in eye care, convened top European cataract-refractive surgeons at the Clareon^® Summit Experience in Cork, Ireland. Scientific sessions were combined by hands-on evaluation of all Clareon^® family IOLs, including Clareon^® PanOptix^® Pro, Alcon’s recently launched innovation. Throughout the event, one theme was continuously reinforced by the leading surgeons: reliable platforms, such as Clareon^®, are the key to maintaining consistent performance and patient results.^1,2,27

“Not all intraocular lenses perform the same, and those differences go beyond just design features,” said Prof. Ramin Khoramnia, during the “Pushing Limits of Innovation” session. “What matters in practice is how consistently the lens performs once it’s in the eye. With the Clareon^® platform, the combination of material properties and manufacturing precision means I can rely on that consistency—from one patient to the next.” ^1,2

Inside the Clareon^® Summit Experience: Seeing innovation firsthand

For participants, visiting the Alcon manufacturing facility in Cork provided a one-of-a-kind experience, offering a deep dive into what sets Alcon Clareon^® Family IOLs apart.

A key differentiator of the Clareon^® material is its high refractive index. This determines how much of the optic contributes to image formation. A higher refractive index enables a larger usable optic, allowing more light to pass through the intended optical zone while reducing reliance on peripheral regions prone to scatter. By contrast, lower refractive index designs often sacrifice edge usability, increasing the risk of visual disturbances from peripheral light.^3-6,28,29

“Material properties play a much bigger role in IOL performance than we often give them credit for,” said Dr. Khoramnia|. “If you look at refractive index, it determines how much of the optic is actually doing useful work. The more of that optic you can use, the more light is directed appropriately, and the less is lost to scatter.”

The visit showcased a carefully structured, multi‑step manufacturing approach where precision and expert human oversight play a central role. Surgeons saw how precise optical curvatures are brought to life through a process in which each component is carefully produced and individually verified, laying the foundation for consistent optical performance from lens to lens.

Dr Merce Guarro| added ”I was impressed by how many times every single IOL is been validated along the process. The number of inspections, at least 41, depending on IOL model, is really giving me confidence in the product predictable outcomes. I’m proud to have this technological jewel in my hands.”

From material preparation to final inspection, strict control of key parameters such as temperature, humidity, and curing conditions helps ensure uniformity and preserves the optical integrity of the Clareon^® biomaterial.

In the Visionarium, a dedicated “hands-on space”, surgeons went through experiential stations comparing visual outcomes across IOL technologies. They had a unique opportunity to step in the shoes of their patients to see through the lens. While performing day-to-day tasks, they could see how differences between IOLs in contrast, clarity, and intermediate vision impact patients’ post-op vision.

“Seeing the manufacturing process firsthand was genuinely impressive. I didn’t fully appreciate that level of precision until I was in the facility,” continued Prof. Coassin|. “And when you pair that with the Visionarium, where you can actually experience how those design choices translate into vision, it really brings it together. It gives you confidence that what’s engineered can be delivered consistently in every patient.”

From technology to clinical performance

During the scientific workshops and plenary session surgeons were able to discover Alcon’s latest innovations.

PanOptix^® Pro (trifocal)

PanOptix Pro was built on the strong foundation and legacy of PanOptix, the leading trifocal IOL with more than 4 million implants worldwide.^{7,8 \} Dr Loh| from the U.S. and Dr Varma| from Canada shared in their workshops that all the great features of PanOptix were kept, whilst decreasing by half the amount of light scatter, from currently 12% to just 6%.^9,10 This was achieved by making very precise and targeted adjustments to the diffractive steps, made possible thanks to the advanced manufacturing process, to increase total light utilization from 88% to an unprecedented 94%, the highest of any reported trifocal IOL.^*°11-17

In addition, PanOptix^® Pro incorporates ENLIGHTEN™ NXT optical technology, designed to enhance contrast across distance and intermediate. Together, these design elements support improved image quality across full visual range.^{^*9}

“In my experience, improvements in contrast and image quality have a clear impact on how patients perceive their vision,” said Dr. Loh|, who co-led the ”From PanOptix^® legacy to next generation of FRoF IOL” session at the event. “With PanOptix^® Pro, I’ve observed more consistent clarity, improved contrast and strong patient satisfaction. That combination gives me greater confidence in recommending trifocal technology to a broader range of patients.”

Vivity^® (non-diffractive EDOF)

While trifocal designs maximize range, non-diffractive extended depth of focus (EDOF) technologies prioritize consistency and reduced photic phenomena. Clareon^® Vivity^® IOLs, which have been implanted in over 2 million patients worldwide, use wavefront-shaping technology to extend depth of focus while maintaining a monofocal-like disturbance profile.^{** †,18-22}

Clinical insights presented at the Summit highlighted its performance at intermediate distances—an area critical for many everyday tasks. Across modeling, bench testing, simulation, and independent clinical comparisons, Vivity has demonstrated strong and consistent outcomes in this range.^23,24

In comparative assessments with TECNIS PureSee^, Vivity^® demonstrated consistent intermediate performance, reinforcing its reliability in clinical practice. Notably, Clareon^® Vivity^® was statistically superior to TECNIS PureSee^ for monocular distance-corrected intermediate visual acuity (DCIVA) at 66 cm (p=0.0032). From a design perspective, reduced pupil dependence further supports stable visual performance across varying lighting conditions. ^{43, 44+}

“Clareon^® Vivity^® has become a go-to option in my practice for patients with more complex ocular profiles,” said Dr. Guarro|, during the ‘Difficult Cases: From Patient Selection to Postoperative Assessment’ session. It delivers strong distance and intermediate vision with a low incidence of visual disturbances. This combination of clinical trial data and real-world experience gives me confidence to offer presbyopia correction to more of my patients” ^{24,45 #}

Clareon^® Custom Match: Expanding patient eligibility

Beyond individual lens selection, the Summit highlighted a shift toward personalized approaches and a growing interest in strategies that combine optical technologies rather than relying on a single IOL type.

The Clareon^® Custom Match strategy pairs different IOLs optic designs optic designs, such as PanOptix or Vivity, across eyes to balance range of vision with tolerance for visual disturbances.²⁶

“The Custom Match strategy allows us to expand the population eligible for presbyopia correction,” said Prof. Labiris|. “By combining approaches, we can better tailor outcomes to individual patient needs. This is particularly valuable for patients with high visual demands who are seeking both functional range and visual comfort.”

He further emphasized the growing relevance of intermediate vision in modern, digitally driven lifestyles and highlighted the importance of systematically measuring intermediate visual acuity (IVA). In this context, Prof. Labiris| referred to assessment tools such as Alcon’s visual acuity cards as well as the DDART‑VC test, a freely accessible tool available for online download.

Addressing real-world challenges in PCIOL adoption

Despite advances in IOL technology, barriers to PCIOL adoption remain, including managing visual disturbances, ensuring predictable outcomes, and integrating workflows efficiently. Summit discussions emphasized reducing variability while simplifying integration into practice. Material consistency and optical stability were highlighted as key contributors to dependable performance, particularly in everyday scenarios like night driving and other low-light environments, where differences may become more noticeable.

Workflow also plays a critical role in adoption and was widely discussed throughout the event. Historically, PCIOL pathways often involve additional steps, increasing operational complexity. Digital tools and standardized processes are therefore essential for improving efficiency and enabling premium IOL adoption at scale sustainably.

“Partnering with Alcon and adopting the Clareon^® collection of IOLs has made a real difference in my practice—clinically, operationally, and commercially,” said Dr. Gundersen|. “When outcomes are consistent, patients are happier and come back with fewer concerns. With a platform like Clareon^®, this consistency can be supported across a range of cases.

Standardized workflows allow me to scale premium IOL delivery without adding complexity, making it more feasible to integrate these technologies into my day-to-day practice.”

Beyond the lens: Enabling consistency through integrated care

Delivering consistent outcomes requires more than lens selection, it requires alignment across every step of the patient journey to support clinical decision‑making and reproducible results.

Within this context, Alcon’s vision for practice partnership is to combine the Clareon^® IOL collection with surgical technologies, digital solutions, and practice support services that work cohesively across the patient pathway—helping surgeons deliver predictable outcomes in a more efficient and scalable way.^30-42§&

“Innovation in cataract and refractive surgery extends well beyond the lens itself,” said Seba Leoni, President of International Surgical Business at Alcon. “Surgeons today are managing increasing clinical and operational complexity, and that requires more than standalone technologies. Our focus is on building an integrated ecosystem of products, digital solutions, and services designed to support surgeons across the entire patient journey.”

Conclusion: Reimagine how IOL performance is evaluated

Evaluating PCIOL performance goes far beyond comparing lenses. It depends on how biomaterial science, optical engineering, and manufacturing quality work together to deliver the best possible real‑world clinical outcomes.

The Clareon^® Summit reinforced that optimized performance also depends on aligning technology and workflow across the patient pathway.

Within this context, Alcon’s approach to platform consistency and practice partnership illustrates how these elements can be brought together in routine care. Through precise engineering and controlled manufacturing, the Clareon® platform is designed to provide a foundation for predictable performance while supporting ongoing innovation.^1,2

©2026 Alcon Inc. 04/2026 IMG-CPR-2600012

Alcon medical device(s) comply with the current legislation for the medical devices. Please refer to relevant products instructions for use for complete list of indications, contraindications and warnings.

^Trademarks are the property of their respective owners.
*Compared to Clareon PanOptix.
|Paid Alcon consultant.
°Based on manufacturer reported values and respective methodology for trifocal IOLs including Clareon PanOptix, Envista Envy, AT Elana, Geometric and Rayner.
^Simulated photopic through-focus point spread function (light intensity [energy])—polychromatic.

\Based on worldwide IOL unit sales, Q1-Q3, 2025.
**Based on worldwide IOL unit sales, Q1-Q3, 2025.
† Based on worldwide IOL unit sales of AcrySof IQ Vivity and Clareon Vivity IOLs, through Q3, 2025

#Monocular UCVA for Vivity vs PureSee^ (n=16 pairs of eyes) at 66 cm 1-month post-op: p=0.0006.
§ Based on the time and motion study conducted in the US (n=92 with UNITY VCS and n=87 with Constellation), on average 5.1 minutes efficiency gain was observed with UNITY VCS in overall OR workflow per vitreoretinal surgery over Constellation (P<0.05). UNITY VCS required on average 27.3 minutes per surgery while Constellation Vision System required on average 32.4minutes per surgery.
& When using a digital, connected surgical planning system.
+N = 80 (40 patients per group); 3-month follow-up. Monocular median distance-corrected intermediate visual acuity (DCIVA) at 66 cm was 0.14 logMAR for Vivity^® and 0.18 logMAR for TECNIS PureSee^ (p = 0.0032). LogMAR values represent median visual acuity, with error bars indicating the interquartile range (IQR). Multiple comparisons were controlled using a post hoc Bonferroni correction; to account for analysis of seven endpoints, the significance threshold was adjusted from 0.05 to 0.0083.