Real-World Refractive and Visual Outcomes of Toric Intraocular Lens Rayone® and Performance of the Raytrace® Calculator
DOI:
https://doi.org/10.48560/rspo.33263Keywords:
Cataract, Astigmatism, Lenses, Intraocular, Lens Implantation, IntraocularAbstract
INTRODUCTION: Considering the growing availability of toric intraocular lenses (IOLs) in cataract surgery, real-world refractive outcome data are needed to aid in the decision-making process and IOL selection. The aim of this study is to evaluate the refractive outcomes associated with the implantation of RayOne®toric IOL, the performance of the Raytrace®OnlinePremiumIOL calculator, and the presence of predictive factors for surgical success.METHODS: A retrospective observational study of 163 eyes who underwent cataract surgery with the implantation of RayOne®toric IOL from May 2022 to March 2023 at Centro Hospitalar Entre o Douro e Vouga, Portugal.
RESULTS: A total of 163 eyes (120 patients, 67 women, average age 73.1±9.0 years) were included. The mean keratometry was 44.13±1.90 diopters (D), and corneal cylinder was -1.99 [-2.40;-1.63] D. Biometry was performed using (1)IOLMaster®500 (Zeiss) in 92 (56.4%) eyes; (2) AL-Scan®(Nidek) in 47 (28.8%) eyes; (3)PacScanPlus®(SonomedEscalon) in combination with TonorefII® keratometer(Nidek) in 13 (8.0%) eyes; and (4)Pentacam®(Oculus) in 11 (6.7%) eyes. The IOL power calculation considered the manufacturer’s provided mean posterior corneal astigmatism (PCA) in 61 (37.4%) eyes. Preoperative best-corrected visual acuity, spherical equivalent (SE), sphere, and cylinder were 0.30 [0.22;0.40] logMAR, -1.17±3.31 D, -0.49±3.00 D, and -1.38±2.02 D, respectively. Postoperatively, these values were 0 [0;0.10] logMAR, -0.41±0.65 D, -0.07±0.58 D, and -0.68±0.78 D, respectively. The difference between manifest refraction and the calculator prediction was SE -0.19±0.63 D, sphere 0.08±0.58 D, and cylinder -0.55±0.78 D. There were no statistically significant differences in manifest refraction or between manifest and calculator prediction in groups with or without PCA inclusion. Differences in the prediction error of the calculator were observed between biometers – EE: 2 and 3 (-0.33±0.67 D vs 0.29±0.69 D, p=0.01), 3 and 4 (0.29±0.69 D vs -0.45±0.91 D, p=0.02); cylinder 3 and 4 (-0.44±0.91 D vs -1.29±0.65 D, p=0.04), 1 and 4 (-0.61±0.76 D vs -1.29±0.65 D, p=0.03). LIO rotation exceeding 10º 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.
CONCLUSION: Ultrasound biometry tends to induce hypermetropia, while Pentacam® undercorrect cylinder compared to other biometers. In real-world scenarios, RayOne®toric IOL and Raytrace®OnlinePremiumIOL calculator demonstrate good refractive and visual results, safety, accuracy in estimated refraction, and rotational stability.
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