Optical Performance And Refractive Predictability Of An Ai-Designed Spiral Optic Vs. A Diffractive Trifocal Iol: Short-Term Comparative Outcomes In Georgian Patients

To evaluate the refractive predictability and optical quality of the Rayner RayOne Galaxy, an AI-designed spiral non-diffractive Full Range of Focus (FROF) IOL, in comparison to the Alcon Acrysof IQ PanOptix diffractive trifocal in Georgian patients undergoing cataract surgery or refractive lens exchange.

Tertiary refractive surgical centers in Georgia.

This study analyzed 146 eyes. Group A (n=32) received the RayOne Galaxy IOL (81% toric), including two postLASIK eyes and one case of sulcus fixation following posterior capsule rupture. Group B (n=114) received the Acrysof IQ PanOptix (87% toric). All patients underwent coneal imaging and only suitable candidates were implanted with FROF IOLs. All Galaxy calculations were performed using the Raytrace platform. All PanOptix calculations were done using Barett Universal II formula and Acrysof Toric Calculator platform. Outcomes were assessed at 1 month postoperatively, focusing on uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, mean spherical equivalent (MSE) and patient-reported outcomes for dysphotopsia.

In Group A - 96% and in group B - 89% of eyes achieved MSE within +/- 0.25 D, with mean UDVA of 0.9 Decimal and higher and J2 for near. The difference between refractive outcomes, UDVA, UIVA and UNVA was not statistically significant. In gorup B, 6% required keratorefractive enhancements.The sulcus-fixated IOL exhibited 10° of rotation.

No halos were reported in Group A; one patient reported transient "rainbow-like" haloes which resolved within 30 days. Notably, both postLasik eyes achieved 1.0 decimal of UDVA with J2 UNVA with no photic phenomena.

Group B exhibited a higher incidence (27%) of dysphotopsia (though none needed IOL explantation) and a significant requirement for precise focal distance adjustment for near tasks.

In this short-term study, both lenses demonstrated excellent refractive and visual outcomes in eyes suitable for trifocal lenses. Both IOL platforms also demonstrated excellent rotational stability. The non-diffractive nature and the spiral design of RayOne Galaxy effectively eliminated the light loss through halo-inducing rings inherent in trifocal technology, providing a continuous range of focus even in complex cases like post-LASIK eyes. These data suggest that spiral optics represents a significant advancement in presbyopia correction, offering the visual range of a multifocal with the safety and contrast profile of a monofocal IOL.