Factors Affecting Visual And Refractive Outcomes Following Bilateral Rayner Galaxy Iol Implantation

To evaluate binocular visual performance, refractive predictability, spectacle independence, and to identify clinical factors affecting outcomes following bilateral implantation of the Rayner Galaxy intraocular lens (IOL).

Single-center prospective study conducted at a private tertiary ophthalmology center. All surgeries were performed by the same experienced surgeon using a standardized femtosecond laser–assisted cataract surgery protocol.

Fifty consecutive patients underwent bilateral cataract surgery with implantation of the Rayner Galaxy IOL. Mean age was 62 ± 9 years; 68% were female. All eyes had preoperative regular corneal astigmatism less than 1.00 diopter (D). Patients were evaluated three months after second-eye surgery. Primary endpoints included binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), refractive accuracy measured by spherical equivalent (SE), spectacle independence, and patient satisfaction using a 0–80 score. Secondary analysis assessed factors associated with suboptimal outcomes, including residual refractive error, posterior capsule opacification (PCO), and pre-existing ocular conditions.

At three months, 88% (44/50) of patients achieved binocular UDVA of 20/20, and 81% achieved J2 or better UNVA. Total spectacle independence was reported by 88% of patients. Refractive accuracy showed 48% of eyes within ±0.50 D and 94% within ±1.00 D of target spherical equivalent. Mean patient satisfaction was 72/80. Factors affecting outcomes included residual refractive error requiring excimer laser enhancement (8%), posterior capsule opacification treated with neodymium-doped yttrium aluminum garnet (Nd:YAG) capsulotomy (4%), and previously undiagnosed amblyopia (2%). No intraoperative complications or intraocular lens exchanges occurred.

Bilateral Rayner Galaxy IOL implantation provided high levels of binocular visual acuity, refractive accuracy, and spectacle independence at three months. Residual refractive error and ocular comorbidities were the primary factors affecting performance. Optimized refractive targeting and careful patient selection are essential to maximize outcomes with advanced intraocular lens platforms.