Eyeworld

52 | EYEWORLD | FALL 2026 R EFRACTIVE References 1. Ribeiro F, et al. Evidence-based functional classification of simultaneous vision intraocular lenses: seeking a global con- sensus by the ESCRS Functional Vision Working Group. J Cataract Refract Surg. 2024;50:794–798. 2. Fernández J, et al. Global con- sensus on the evidence-based functional classification of simul- taneous vision IOLs. J Cataract Refract Surg. 2026;52:219–222. 3. Rocha KM, et al. A compar- ative analysis of tolerance to induced astigmatism across various categories of intraocular lenses. J Cataract Refract Surg. 2026. Online ahead of print. by Karolinne Rocha, MD, PhD Refractive Editor IV, MD, and Robert Weinstock, MD. One lens that was not mentioned is the RayOne Galaxy (Rayner), an AI-designed spiral technology. The novel technologies mentioned in this article all represent progress and refinement, in optimized optic chromatic aberration, dysphotopsias, and contrast sensitivity, to name a few. Tolerance to induced astigmatism (TIA) is an emerging concept that could add to the glob- al consensus. In "Understanding lens tolerance to refractive error and astigmatism," where I was joined by Francesco Carones, MD, in con- tributing, we discuss our recent studies in this area. For my part, our study found that patients tolerate more with-the-rule (WTR) astigmatism in a comparison across different IOL categories with TIA up to 2.0 D in different orientations. 3 In addition, we found novel full range of vision (full DOFi) IOLs provide a higher tolerance for residual refractive error. 3 Now we know that more light transmission and improved optics and materials, coupled with the appropriate lens selection and preop evaluation, provide the best opportunity for success of our patients. My colleagues and I will continue to expand our research in this area. As we look to the future, ophthalmology will continue to rewind, looking at where we've been, refresh, what we've been doing well, and refine, what we can improve, for the betterment of our patients' vision. Rewind, refresh, and refine for the betterment of patients' vision R efractive cataract surgery continues to advance on the techniques and technologies we use to improve visual quality in our patients. This is particularly evident when discussing IOL technologies, where innovation has put ophthalmology so far ahead that ASCRS joined its global partners to create a classi- fication system, building on the work begun in 2024, rewinding a few years as we look to refresh and refine the tools available to meet patients' visual needs. 1 Earlier this year during Refractive Day at the ASCRS Annual Meeting, Daniel Chang, MD, described the work of this combined Function- al Vision Working Group to establish a unified framework and standardized vocabulary for the growing novel lens technologies available. Dr. Chang's talk and the framework, published in the Journal of Cataract & Refractive Surgery, 2 centered on three core domains: visual range, visual quality, and visual symptoms. We continue to refresh and refine our craft in this issue with "Evolving roles for LAL and full range of vision IOLs," including contri- butions from Douglas Koch, MD, Yuri McKee, MD, and Beeran Meghpara, MD. As Dr. McKee explains, despite our best efforts in eliminat- ing it, refractive surprises persist for groups of patients, specifically those who are post-refrac- tive surgery. Based on data at his disposal, Dr. McKee indicates the rate at which surgeons hit the refractive target for their patients is about 92% for full depth of field (DOFi) IOLs. But that number rises to about 97% with the LAL. Dr. McKee attributes this favorable comparison to the approach: "we're treating the lens based on the true postop outcome." Dr. Meghpara, mean- while, reminds us that full DOFi IOLs continue to be great options to reach full vision range in those patients who want to be independent from spectacles. "Presbyopia-correcting IOLs: the new kids on the block," features physicians' hands-on experience with new lenses on the market in the extended and full DOFi categories, thanks to Priya Mathews, MD, MPH, George O. Waring Dr. Rocha as a resident in 2010 Source: Karolinne Rocha, MD, PhD REFRESH. REFINE. REWIND.

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