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For instance, if this IOL is used with no monovision offset, it offers spectacle independence similar to that provided by available extended depth of focus IOLs. The level of spectacle independence sits between traditional monofocal IOLs and trifocal IOLs, depending on how the IOL is used. Compared with a standard monofocal IOL, RayOne EMV provides better intermediate vision, with 1.25 D of extended range of vision on average. The diffractive-free design reduces the likelihood of dysphotopsia, which should increase patient satisfaction. The patented feature that sets it apart is enhanced spherical aberration in the center of the lens that gradually reduces at the periphery, allowing for an increased range of functional vision. The appearance of the IOL’s optic, even under microscopic conditions, is much like that of other monofocal IOLs, with no zones or rings. From a patient perspective, this allows for more blended vision between the two eyes, which has been reflected in positive patient feedback. In fact, a unique feature of RayOne EMV is a stretched focal point that allows the near eye to contribute to distance vision, even with a -1.0 D offset.

The IOL is designed to optimize for monovision with an expectation of excellent binocular distance vision. As a result of these properties, the patient has clear binocular vision more often than would be possible with a standard monofocal IOL used in the same way, reducing the likelihood of patient complaints related to asthenopia and other effects associated with transitions between near and far vision.

In addition, the dominant eye is more forgiving of postoperative myopic outcomes compared with extended depth of focus IOLs based on negative asphericity or phase shift technology. Results from early testing showed that this new lens can provide on average 2.25 D of extended depth of vision when using a 1 D monovision offset. The enhanced monofocal IOL we developed (RayOne EMV) provides an extended range of vision and is the only available IOL optimized for use with monovision. We are increasingly recognizing the value of better presbyopia correction, as individuals are more likely to engage with screens at near focus in their daily work and leisure time. To make this concept a reality, I partnered with the R&D team at Rayner to research, develop, and bring to market a patented technology: an aspheric IOL with an optimized level of positive spherical aberration designed for use when monovision is sought in cataract surgery. Positive spherical aberration achieves consistent visual acuity and maintains a smoother transition between distance, intermediate, and near vision. Positive, rather than negative, spherical aberration is the key to a modest monofocal approach because it acts in a synergistic fashion with myopia, providing a greater overlap or blending between the distance and near sight on the respective eyes.

I spent many years considering whether it would be feasible to design a custom IOL to specifically enhance this strategy – all of which led me to the concept of positive spherical aberration to extend the depth of focus of a monofocal IOL. However, these options are not without their downsides, as patients may experience a higher rate of night vision disturbances, halos, or glare that reduces their satisfaction with the procedure.Īs a result of these ongoing challenges, I began my pursuit of a consistent strategy for modest monovision as early as 2008 to provide a better balance between distance and near vision.

MODEST EYES FULL

In patients who have expressed the desire for full spectacle independence, multifocal lenses are often considered. When choosing an intraocular lens in patients undergoing cataract surgery, we are often challenged with a patient’s desire to achieve adequate distance vision while maintaining some degree of spectacle independence for near vision.

Modest eyes