Lens Options

Vivity vs PureSee: A Cataract Surgeon Compares Both Lenses

By Todd Driver, MD · Board-Certified Cataract Surgeon, Irvine, CA

Medically reviewed by Todd Driver, MD · August 2026

If you are choosing between the Vivity lens and the new PureSee lens for your cataract surgery, here is the short version. In my hands, these lenses are more alike than different. In the two 2026 studies that put them head to head, distance vision was a tie and near vision was a tie. Vivity was slightly better at arm's length. PureSee measured better on fine detail contrast, and that was the one difference that reached statistical significance.

Both are extended depth of focus lenses, which means the real decision usually happens one step earlier: EDOF or trifocal. I will cover that first, because it matters more than the brand.

Trifocal vs EDOF: the decision that comes first

When I discuss cataract surgery with my patients, a lot of the time they are deciding between two lens families. A trifocal lens gives you very good near vision, close to your face, small print, and distance is very good too. The trade-off is faint halos around lights at night. An extended depth of focus lens flips that. Nighttime is better and glare and halos are much less of an issue, but close is not quite as good. You hold things a little further from your face.

The published numbers back that up. In a four-way comparison of lens types, about 74 percent of EDOF patients and 92 percent of trifocal patients did not need glasses after surgery, while roughly 14 percent of EDOF patients and 38 percent of trifocal patients reported glare and halos at night. So the trifocal buys you reading vision and costs you a little night quality. The EDOF buys night quality and costs you a little reading. Neither is a bad outcome. They are different trade-offs.

Both lenses in this comparison are EDOF lenses. If reading small print without glasses is your top priority, a trifocal conversation may serve you better, and I cover that in my premium lens comparison.

How the Vivity lens works

Vivity is made by Alcon. It has been implanted since 2020 and it is the most implanted extended depth of focus lens in the world. There are no diffractive rings. Instead, a small raised element in the center of the lens, a transition zone, takes one point of focus and stretches it into a longer one. Nothing splits the light into competing images.

The night vision data reflects that design. In the trial that supported its approval, halos were reported by under one percent of patients and glare by under four percent, both essentially the same as a standard single focus lens. Alcon then followed more than 900 patients across eight countries in a real-world registry, and over 91 percent reported no halos, no glare, and no starbursts at all.

The contrast warning on Alcon's own label

There is one catch, and Alcon prints it on their own label: most patients with this lens are likely to experience a loss of contrast sensitivity compared to a single focus lens. In practice, that does not mean blurry vision. It means telling charcoal gray from black on a rainy night is a little harder. Most people never notice. Some do.

This is why thorough pre-operative screening matters. If you have a condition like macular degeneration that already reduces your contrast sensitivity, it is generally best to avoid this lens.

How the PureSee lens works

PureSee is Johnson & Johnson's new EDOF lens. The FDA approved it in March 2026, with a full United States rollout in June. It has no rings and no central element either. The back surface of the lens changes curvature continuously across the whole optic, and the front surface is designed to cancel the natural aberration in your cornea. It is a purely refractive lens, about as optically clean as a premium lens gets.

That design earns it a real distinction: PureSee is the first and only extended depth of focus lens approved in the United States without a contrast sensitivity warning on its label. It is worth understanding what that means, because it gets oversold. The regulatory bar is a specific measured difference from a single focus lens. PureSee came in under the bar. Vivity did not. It is a real result, and it is not proof that one lens beats the other in your eye.

Vivity vs PureSee: what the head-to-head studies found

Two studies published in 2026 have compared these lenses directly, and they agree with each other. Distance vision was the same. Near vision was the same. At arm's length, Vivity was a little better. On fine detail contrast, PureSee was a little better.

The contrast finding matches what I would have guessed from the design. PureSee has no central element in the light path, so there is less structure and less to scatter. The studies support that.

Both studies were small, retrospective, and limited to a couple of months of follow-up, so I hold these findings loosely. The randomized trials comparing these two lenses directly are still running. Overall, both are excellent lenses, and in my own practice I am finding they produce similar outcomes.

What I see at the one-week visit

Here is something I have learned watching these patients at their first post-op visit, and I have never heard anyone say it out loud.

Every so often, a trifocal patient comes in unhappy with halos at night. Generally that is due to dry eye. The ocular surface is still recovering from surgery, and a dry, irregular surface makes halos dramatically worse than they will ultimately be. After the dry eye gets under control, the halos improve, patients adapt, and they love their near vision.

The extended depth of focus patients are the mirror image. I have essentially never had one complain about halos at night. What I do hear is that they wish their near vision were a little better. That is the honest split. Neither is a bad outcome. They are simply the different shortcomings of each lens.

Which lens should you choose?

If your day revolves around a countertop, a dashboard, and a computer screen, either of these lenses will serve you well. If you want to read small print without reaching for glasses, you should be having a trifocal conversation instead.

Whichever way you lean, what predicts your happiness a year from now is not the brand of the lens. It is whether your surgeon measured your cornea carefully, examined your retina and ocular surface, asked how you actually spend your day, and told you the truth about the trade-offs.

Two interactive tools can help you compare your options: see how each lens type handles daytime detail and night driving in the interactive lens simulator, or take the 60-second lens quiz to see which option fits how you live.

Sources: This article draws on the Alcon Clareon Vivity directions for use and FDA approval data, the AcrySof IQ Vivity pivotal trial and multicenter real-world registry, the TECNIS PureSee US approval announcement (March 2026) and its randomized comparison against an enhanced monofocal, and the two 2026 retrospective head-to-head comparisons of Vivity and PureSee published in the peer-reviewed ophthalmology literature, along with comparative studies of monofocal, EDOF, and trifocal lens outcomes.

Related reading: comparing premium cataract lenses, brand by brand · the Light Adjustable Lens in Irvine · cataract surgery in Irvine · or book a cataract consultation in Irvine.

This article is for general education and is not medical advice. It does not create a doctor-patient relationship. Lens selection depends on your individual eye anatomy, ocular surface, retinal health, and visual goals. Please discuss your options with your own surgeon.