Clinical Evaluation Of Rayone Emv And Emv Toric Iols In Complex Clinical Settings: A Study Of 97 Georgian Eyes

To evaluate the clinical efficacy, refractive predictability and rotational stability of the RayOne EMV non-diffractive Extended Range of Vision intraocular lens (IOL) platform. The study specifically assesses the IOL's performance in "worst-case" scenarios, including Exfoliation Syndrome (XFS) with varying degrees of zonular instability and eyes with reduced contrast sensitivity due to glaucoma, epiretinal membrane (ERM) and dry AMD. The objective was to determine if this platform provides a reliable functional range of vision in eyes where traditional diffractive optics are often contraindicated.

Private tertiary surgical center 

A prospective study of 97 eyes undergoing cataract surgery was conducted. The cohort included a significant sub-group with XFS (31%), as well as retinal disorders (7% dry AMD, 6% epiretinal membrane) and eyes with mild to moderate stages of primary open angle or exfoliation glaucoma (16%). All IOL power and alignment calculations were done via Rayner’s proprietary Raytrace calculator and 82 non-toric, 16 toric lenses where used. Primary endpoints included uncorrected distance (UDVA) and intermediate (UIVA) visual acuity, mean rotational stability, and patient-reported dysphotopsia.

Raytrace calculations achieved a mean spherical equivalent within +/-0.25D of plano in 92% of cases. In the XFS subgroup, 16% received toric models, demonstrating exceptional stability with a mean rotation of <3.0 degrees, same as non-XFS eyes. Notably, 18% of cases where 0.75D toric lens was proposed but a spherical IOL was implanted, the patients showed high tolerance to residual astigmatism. Mean postoperative UDVA was 1.0 Decimal in healthy eyes and UIVA was J2/J3 at 60cm. In eyes with glaucoma and macular comorbidities, where visual function is dependent on neural and retinal functions, there was a 0% incidence of disturbing halos or glare with well-preserved contrast sensitivity and good functional patient-reported intermediate vision

The RayOne EMV platform including toric models, is a perfect choice for complex eyes. Its non-diffractive optic provides a functional range of vision without the photic phenomena of diffractive designs, making it ideal for eyes with compromised neural function and offers monofocal-like performance. The platform's high rotational stability in XFS eyes and tolerance to residual cylinder confirm its reliability in achieving high patient satisfaction, especially in comorbid cases. This study demonstrates that excellent refractive outcomes are achievable even in "worst-case" scenarios when combining advanced formulas with stable, tilt-tolerant IOL designs.