When facing the unpredictable nature of glaucoma, one eye surgeon turns to an intraocular lens that provides stability and strong outcomes he can rely on.
For Sydney ophthalmologist Dr Season Yeung, the hallmark of Johnson & Johnson (J&J)’s TECNIS intraocular lens (IOL) platform is simple: predictability.
Across a patient mix that spans routine cataract to complex glaucoma and corneal disease, he says the TECNIS family has consistently delivered the dependable refractive outcomes his practice is built on.
“I’ve used the TECNIS platform since the start of my consultant career,” he says. “I like the predictability of the lens. You know what you’re going to get.”
That reliability, he notes, extends into his glaucoma cohort – an increasingly important part of his caseload.
“For my glaucoma patients, I’ve never had reservations about using a TECNIS monofocal lens. Regardless of the glaucoma stage, I know they’re going to get good visual acuity and a stable outcome.”
The reassurance of visual stability is something Dr Yeung considers fundamental for these patients.
“Many glaucoma patients just want to keep driving,” he says. “A good monofocal lets them do that without glasses. It’s safe and it’s dependable – you won’t go wrong.”
His long-standing familiarity with the platform, paired with the support he receives from J&J, reinforces that trust.
“Whenever a new technology comes out, I get a lot of information and support beforehand,” he says.
“Safety is always my top priority, and having that access gives me confidence before using anything new.”
A practice shaped by diverse needs
Dr Yeung operates in both private and public settings, with rooms in Burwood and Eastwood, Sydney, and appointments in mixed-demographic hospital clinics.
His private patient base, however, has a particularly large Asian and Chinese representation. “And within that group I manage everything from cataract and glaucoma to corneal dystrophies and keratoconus. It’s a very diverse pathology mix.”
That diversity, combined with a high proportion of chronic diseases, has led him to refine a meticulous pre-operative process.
“I do a comprehensive preoperative assessment, including optic nerve function, visual field status, intraocular pressure control, lifestyle, occupation, and hobbies. All of that determines what lens is appropriate for each particular patient.”
And when glaucoma is involved, the nuances matter even more, he says.
J&J Vision’s TECNIS platform has long been marketed around optical clarity, chromatic aberration correction, and consistent refractive behaviour.
Its modern family members, including the monofocal TECNIS, Monofocal Plus TECNIS Eyhance, and the extended depth of focus TECNIS PureSee, share a common aberration-correcting optic and stability-focused design.
It’s that consistency across generations that Dr Yeung believes has made the lenses a mainstay for many surgeons.
He acknowledges he uses other manufacturers’ lenses selectively, but TECNIS remains the backbone.
“The predictability is the primary reason. Whether it’s a monofocal lens or one with newer technology, I would know the behaviour of these lenses.”
Glaucoma and contrast: walking the line
A key consideration with any advanced-technology IOL in glaucoma is contrast sensitivity.
“Glaucoma reduces contrast – sometimes even early on – and that correlates with the extent of the disease,” he explains.
Ageing reduces contrast too, compounding the effect.
This is where Dr Yeung believes careful stratification is essential. He outlines his selection framework:
• Advanced or severe glaucoma “ monofocal only
• Early or stable moderate glaucoma with central field intact “ consider extended depth of focus (EDOF)/monofocal plus
• Any irregular cornea or unpredictable biometrics “ proceed cautiously with any premium lens
“If a patient has advanced disease or poor contrast sensitivity, using an EDOF lens means less light reaching the retina. That’s not a good combination,” he says.
“But in early or stable moderate glaucoma, where the central field is fine, they can gain very useful intermediate vision.”
This matters for day-to-day tasks – cooking, mobile phone use, computer work – all areas where the TECNIS EDOF class, including the PureSee, is designed to give functional range without the compromises of a full multifocal optic.
If there is a theme that runs through Dr Yeung’s decision-making, it is expectation management.
“The most important thing is a thorough conversation,” he says. “I ask about driving, reading, work, hobbies – everything. The lens choice has to match the lifestyle.”
He lists several checkpoints he uses before recommending any lens, especially in glaucoma:
• Glaucoma severity and stability
• Intraocular pressure (IOP) control
• Drop compliance (“if a patient does not use his/her medication every day, that can be a problem”)
• Selective laser trabeculoplasty (SLT) history and pressure behaviour
• Optic nerve appearance
• Visual field pattern
• Retinal and macular comorbidities
“If the pressure isn’t stable, I would address that first. Sometimes they need more counselling around compliance; sometimes SLT would be a better option. I need stability before I proceed.”
He also emphasises that irregular corneas remain a universal caveat. “It’s not an issue with the TECNIS platform – any lens calculation becomes less predictable in those eyes. You just need to counsel accordingly.”
When EDOF works well: a standout case
One glaucoma case in particular remains memorable for Dr Yeung: a patient with well-controlled glaucoma and a small degree of peripheral visual field loss, who was unaware the disease could influence his cataract outcome.
“With counselling, I learned he still wanted to drive, but he also really wanted to read unaided,” he says.
Dr Yeung decided on a blended EDOF strategy, targeting distance in his dominant eye and a touch of myopia in the other (mini monovision).
“He ended up completely spectacle independent. He can drive without glasses, and he can read or look at his phone. He was extremely happy.”
These outcomes, he says, are why he offers EDOF selectively in glaucoma.
Across the TECNIS range, patient satisfaction has been strong, he says.
“Most patients are very happy. After cataract removal, they notice the colour and contrast improvement, and the TECNIS optic gives them a very crisp distance result.”
He notes that glare and halo remain possible even with monofocals – “it’s not unique to TECNIS” – but says he has yet to see significant halo reports with the TECNIS PureSee.
“With trifocals, patients do sometimes complain of photopic phenomena, which can certainly be expected and should be an integral part of the counselling. But with the non-diffractive EDOF lenses, I haven’t had any serious complaint.”
From a surgical perspective, Dr Yeung describes the TECNIS lenses as straightforward to implant. “The new Simplicity injector is smooth and very easy to use. The implantation is stable and predictable.”
For glaucoma patients, his main modification relates not to the lens, but to the incision.
“I make my incision temporally so I avoid damaging conjunctival tissues that might potentially be needed for future filtration surgery.”
Explantation, he notes, is fortunately rare in his hands. “I haven’t needed to exchange many lenses. Any lens becomes difficult to remove after a long time, so that’s why pre-operative communication is crucial. If the patient is happy from the beginning, we avoid that issue.”
Why he recommends TECNIS
For Dr Yeung, the argument for TECNIS in glaucoma patients – particularly for monofocal and monofocal-plus classes – is straightforward.
“The TECNIS platform is suitable for glaucoma patients at any severity level,” he says. “If they want functional intermediate or near vision, and they are early or stable moderate disease, then monofocal plus or EDOF designs can be considered.”
He stresses that anatomical normality and central visual field preservation are essential prerequisites for premium technology – but when the criteria fit, the outcomes are strong.
And in the background, the company support remains a major factor. “J&J is very helpful. I get the right information when new products come out, and that support matters when you’re adopting new technology.”
Glaucoma, with its variable progression and contrast-related limitations, is often an area where surgeons opt for the most conservative lens choice.
For Dr Yeung, the TECNIS platform allows that conservatism when needed, but also provides additional flexibility for carefully selected patients who want more from their visual outcome.
This article is intended for healthcare professionals and provides general information only. This article reflects the views and opinions of Dr Season Yeung. These views and opinions are not indicative of all outcomes and should not be interpreted as a guarantee or warranty for similar experiences or results. Individual patient results may vary.
