Real-World Refractive And Visual Outcomes Of Toric Intraocular Lens Rayone® And Performance Of The Raytrace® Calculator

This study aims to assess the refractive outcomes of cataract surgeries involving RayOne® toric intraocular lens (IOL) implantation, evaluate the performance of the Raytrace® Online Premium IOL calculator, and identify predictive factors for surgical success. Amidst the increasing availability of toric IOLs, such real-world data are crucial for optimizing decision-making processes and IOL selection in clinical practice.

Department of Ophthalmology, Unidade Local de Saúde Entre o Douro e Vouga, Santa Maria da Feira, Portugal.

A retrospective observational study included 163 eyes from 120 patients who underwent cataract surgery with RayOne® toric IOL. Various biometry devices were used for measurements: IOLMaster® 500 in 56.4% of cases, AL-Scan® in 28.8%, a combination of PacScan Plus® and Tonoref II® keratometer in 8%, and Pentacam® in 6.7%. The study evaluated preoperative and postoperative visual acuity, spherical equivalent (SE), sphere, and cylinder. It also examined the accuracy of the Raytrace® Online Premium IOL calculator, including analyses with and without considering the manufacturer's provided mean posterior corneal astigmatism (PCA).

Participants averaged 73.1±9.0 years of age, with significant improvements in postoperative best-corrected visual acuity (BCVA) and reductions in SE, sphere, and cylinder. The comparison of manifest refraction to calculator predictions showed minor differences (SE -0.19±0.63D, sphere 0.08±0.58D, and cylinder -0.55±0.78D), indicating high accuracy of the Raytrace® calculator. The study found no significant difference in refractive outcomes based on PCA inclusion but noted significant variances in prediction errors between different biometers. LIO rotation exceeding 10 degrees occurred in 5 cases, with one requiring repositioning, posterior capsule rupture in one case, and human error in IOL calculation or ordering in two cases.

The RayOne® toric IOL and Raytrace® Online Premium IOL calculator demonstrated excellent refractive outcomes, safety, accuracy in estimated refraction, and rotational stability in a real-world setting. While ultrasound biometry tended to induce hypermetropia and Pentacam® undercorrected cylinder compared to other biometers, the overall effectiveness and reliability of these tools in predicting and achieving desired refractive outcomes post-cataract surgery were confirmed.