The Effect Of Pupil Size, Kappa Angle, And Spherical Aberrations On Visual Acuity After Implantation Of A New Full-Range Of Field Premium Iol (Rayner Galaxy)

To assess the influence of pupil size, ocular alignment (angle kappa), and preoperative corneal spherical aberration on the clinical performance of a novel full range of field IOL, as measured by visual acuity, defocus curve profiles, and patient-reported outcomes.

Ooginstituut Aalst, Aalst, Belgium

This prospective observational study involved adults (≥22 years) undergoing phacoemulsification with Galaxy IOL implantation. Data were collected preoperatively and at 1 and 3 months postoperatively. Outcomes included monocular uncorrected and distance-corrected visual acuity (distance UDVA, CDVA at 6 m; intermediate UIVA, DCIVA at 66 cm; near UNVA, DCNVA at 40 cm), manifest refraction, monocular and binocular defocus curves, and patient-reported outcomes via the RayPRO questionnaire.

A total of 92 eyes from 48 patients (16 males, 32 females; mean age 64.0) were included. At 3 months, monocular logMAR UDVA, UIVA, and UNVA were 0.02 ± 0.08, 0.08 ± 0.17, and 0.10 ± 0.16, respectively. Mean MRSE at 3 months was -0.14 ± 0.25 D. The binocular defocus curve at 3 months showed functional vision (≤0.2 logMAR) from +1.0 D to -2.8 D (down to 35.7 cm reading distance). Kappa angle and preoperative corneal spherical aberration had no statistically significant effect on the 1-month monocular defocus curve. Photopic and mesopic pupil size had a statistically significant but negligible effect on visual acuity. Patient satisfaction was high, with minimal reports of visual disturbances and a high level of spectacle independence. 

RayOne Galaxy IOLs demonstrated consistent visual performance across all distances, with high levels of spectacle independence and patient satisfaction; and minimal dysphotopsia, regardless of pupil size, kappa angle, and preoperative corneal spherical aberration.