Brisbane specialist ophthalmologist Dr Matthew Russell shares his early experience with the Tecnis Odyssey intraocular lens (IOL) – Johnson and Johnson Vision’s latest premium IOL, highlighting excellent patient outcomes and refined surgical efficiency.

WRITER Melanie Kell

The landscape of premium intraocular lens technology continues to evolve, with manufacturers working to address the inherent compromises that have traditionally limited patient satisfaction with multifocal platforms.

Johnson and Johnson’s latest addition to the Tecnis family, the Tecnis Odyssey IOL, represents a significant advancement in this pursuit, combining extended depth of focus (EDOF) technology with multifocal optics to deliver what the company describes as continuous, uninterrupted vision at all distances.

Built on the established Tecnis platform, the Tecnis Odyssey features a freeform diffractive profile engineered to eliminate the traditional gaps between near, intermediate, and far distances that have characterised earlier multifocal designs.

Dr Matthew Russell, founder of OKKO Eye Specialist Centre and VSON Vision Correction Specialists in Brisbane, has been among the early adopters of the Tecnis Odyssey IOL in Australia. His initial experience with approximately 40 patients provides valuable insights into the real-world performance of this hybrid EDOF-multifocal technology.

EARLY ADOPTION AND INITIAL IMPRESSIONS

Dr Russell’s introduction to the Tecnis Odyssey IOL came through the traditional channels of professional development – journal publications announcing United States Food and Drug Administration (FDA) approval and subsequent industry communications. However, it was the direct feedback from American colleagues that proved most influential in his decision to adopt the technology.

“The feedback from these colleagues indicated that patient satisfaction rates were very high, primarily due to the improvement in image quality, particularly distance and near visual function after implantation,” Dr Russell explained. This early positive feedback from the United States market, where the lens launched ahead of the Australian release, provided confidence in the technology’s clinical potential.

Dr Russell’s patient cohort has consisted almost exclusively of individuals undergoing refractive lensectomy surgery – a demographic that typically demands the highest levels of visual performance and has limited tolerance for compromise. This patient selection reflects both the premium nature of the technology and the exacting standards required for success in the refractive surgery market.

IMMEDIATE CLINICAL OUTCOMES

Perhaps the most striking aspect of Dr Russell’s experience has been the rapidity of visual recovery. “What surprised me was that the improvements in vision quality were evident as soon as the day one postoperative appointment,” he observed. “Many of these patients had unaided vision of 6/6 for distance and unaided near vision of N5.”

While such visual acuity levels are not uncommon following refractive lensectomy, Dr Russell was surprised by patients on day one reporting “that their vision was already very clear, and, in many cases, they were already quite satisfied with the results of their surgery”.

“This is unusual for patients in the early phases of recovery from refractive lensectomy surgery using the existing multifocal IOL platforms,” he said.

This early satisfaction appears to stem from the continuous range of vision provided by the hybrid design. Dr Russell said his patients have demonstrated “a much more continuous vision range than traditional trifocal intraocular lenses”, with most reporting adequate vision for computer use at 60–70 cm and excellent near vision performance, even in relatively dim lighting conditions.

ENHANCED TOLERANCE AND REDUCED ENHANCEMENT RATES

One of the most clinically significant advantages observed with the Tecnis Odyssey IOL is its improved tolerance to residual refractive errors, particularly when compared to Tecnis Synergy. The incorporation of EDOF technology into the multifocal design appears to provide a buffer against minor postoperative refractive surprises that might otherwise compromise patient satisfaction.

“Patients are far less impacted by minor residual myopic refractive errors up to -0.5 dioptres spherical equivalent,” Dr Russell explained. “We’ve seen several patients who maintain clear distance vision despite having a residual postoperative refraction of -0.50 DS or -0.25 DS with 0.5 DC.”

This tolerance has practical implications for both surgeon and patient. “It is really too early to say, but these results will likely translate into lower levels of refractive enhancement required to achieve outcomes that patients are happy with,” Dr Russell noted. “Fewer enhancements also lower the risk for the entire process of undergoing refractive lens exchange and presbyopic correcting cataract surgery.”

SURGICAL EXPERIENCE AND DELIVERY SYSTEM

The Tecnis Simplicity Delivery System has received particular praise from Dr Russell’s surgical team. The preloaded design and straightforward preparation process have improved surgical workflow and reduced the burden on nursing staff, freeing them to focus on other aspects of surgical support.

“I found the delivery system very easy to use. More importantly, our surgical nursing team was particularly impressed with it,” Dr Russell told mivision. “The intraocular lenses are preloaded, and preparing the lens during surgery is straightforward and quick. This means that our scrub nurses are not distracted by the onerous task of loading intraocular lenses and are available to assist the surgeon. This has really improved our surgical flow.”

PATIENT SELECTION AND CLINICAL APPLICATIONS

Dr Russell said this new lens is an ideal choice “for patients who prioritise excellent near vision, especially in challenging lighting conditions”.

“The J&J Odyssey intraocular lens is an excellent choice for patients who prioritise near vision, particularly under dimly lit situations, which can range from reading menus in restaurants in the evening to performing work-related activities,” Dr Russell said. “Patients who work in the construction or mining industries, or first responders where glasses can be impractical and the lighting can sometimes be poor are particularly well suited. Even healthcare workers, such as doctors and nurses, who need to read drug labels and expiry dates in emergencies would benefit from this implant.”

Additionally, he said the Tecnis Odyssey IOL is an ideal choice for those who are blur intolerant and may not adapt well to the loss of contrast sensitivity function commonly associated with existing multifocal intraocular lenses.

“In these patients, we would have previously elected to use EDOF intraocular lenses and perhaps not achieved a high level of spectacle independence for near.

“The Odyssey implant combines all the benefits of EDOF and multifocal technology in a single implant, increasing the range of patients who can benefit from multifocal technology to achieve a high level of spectacle independence for near vision.”

PERFORMANCE IN CHALLENGING CONDITIONS

Low-light performance has emerged as a particular strength of the Tecnis Odyssey platform with Dr Russell observing that “the J&J Odyssey lens certainly performs noticeably better than existing trifocal intraocular lenses under low-light conditions, except for the J&J Synergy implant. However, the Odyssey markedly outperforms the Synergy implant regarding tolerance of small residual refractive error and image quality for distance.”

This combination of enhanced low-light capability with improved contrast sensitivity appears to translate into better real-world visual function, particularly for activities such as night driving.

MANAGING EXPECTATIONS AND PHOTIC PHENOMENA

Despite the advances represented by the Tecnis Odyssey platform, Dr Russell said comprehensive patient counselling regarding the limitations and side effects associated with multifocal IOL technologies remains critically important.

“Patients with the J&J Odyssey intraocular lens implanted still experience haloes, as with any other multifocal implant,” he stated. “It is still essential that all patients receiving this implant are extensively counselled regarding halo glare and starburst, as well as the potential impact of this on night driving.”

However, the improved contrast sensitivity function appears to mitigate some of these concerns. Dr Russell reported that all his patients had been able to return to night driving within the first two weeks of surgery, and the overall impact of photic phenomena appeared to be reduced compared to previous multifocal platforms.

Similarly, with a more continuous range of clear vision between the near and intermediate distances than traditional trifocal platforms, only one of Dr Russell’s patients has struggled with computer use in the first month after treatment.

“I suspect an element of neuroadaptation is at play, as well as ocular surface disruption, which is commonly associated with surgery and the postoperative eye drops. This patient noticed their intermediate vision deteriorating after two or three hours of continuous computer work, but subsequently improved.”

Dr Russell believes it’s the cognitive load of computer work that can disrupt neuroadaptation.

“The effect of intense computer work on the ocular surface is well documented, and this tends to be exacerbated following any lens surgery. I suspect neuroadaptation will still be an issue for some patients, and that may compromise their satisfaction with intermediate or near vision. However, we have not had enough experience with the intraocular lens to understand the proportion of patients who may be affected in this way.”

With the process of neuroadaptation remaining variable and unpredictable, he said adaptation may take several months for some patients, and a small proportion may never achieve satisfactory adaptation, potentially requiring lens exchange.

FUTURE IMPLICATIONS AND EARLY SATISFACTION

Dr Russell’s experience of zero patient dissatisfaction across 40 implanted patients represents a marked improvement over historical multifocal outcomes, though he acknowledges the limited follow-up period.

“Compared to the experience we would typically have with a traditional trifocal platform, this group of patients is doing tremendously better at this early stage,” he observed. “Two particular aspects stand out: the apparent elimination of patients requiring subsequent laser vision correction, and the absence of distance vision dissatisfaction.”

These early outcomes, while requiring longer-term validation, suggest that the hybrid EDOF-multifocal approach may represent a genuine advancement in addressing the traditional compromises associated with premium IOL technology.

This article is sponsored by Johnson and Johnson Vision.

The views and opinions expressed in this interview are those of Dr Matthew Russell based on his personal experience. They do not necessarily represent the opinion of Johnson & Johnson. Dr Matthew Russell has not received financial reimbursement or payment for this interview. 2025PP14401