New report reveals Rayner lenses are “very surgeon friendly”

In a review of five years continuous experience of implanting Rayner’s Rayacryl^® lenses, surgeons Peter 

Bacon and Ashok Vyas from Scarborough Hospital, North Yorkshire, UK, jointly pronounce Rayner’s injectable lenses to be “very surgeon friendly” with an “excellent post-operative refraction accuracy”.

Having now implanted nearly 10,000 lenses in a variety of clinical scenarios, both surgeons are well 

qualified to pass judgement and in a reference to Rayner’s own hydrophilic acrylic biomaterial, Rayacryl®, they describe the performance as being “spectacular” with not a single reported case of biodegradation including opacification or calcification.

This marks an important landmark in the history of the Rayacryl®family of lenses and with the recent 

introduction of the innovative and unique Enhanced Square Edge, which is designed to present an even greater barrier to cell encroachment thereby reducing the potential for Posterior Capsular Opacification (PCO), the future for C-flex® and Superflex® is assured.

Long term performance of Centerflex® lens implant made from the Rayacryl® material

The currently available Rayacryl® foldable lens implant range includes C-flex® and Superflex® lenses. Rayacryl® is a hydrophilic acrylic material with 26% water content and refractive index of 1.46 in a hydrated state. Their precursor Centerflex® lens which is made from the same Rayacryl® material has been the lens of choice at the Scarborough hospital, Scarborough, UK from September 1999. This lens is now implanted in nearly 10,000 eyes and in a variety of clinical scenarios.

The performance of Rayacryl® material has been spectacular in these eyes.

1. In a study of 200 eyes examined at three years on slit lamp (awaiting publication), the Centerflex® lens material was found to be completely clear. Every hydrophilic lens material is different so is the process of lens manufacturing. In fact lenses made from different hydrophilic material have their own typical appearances on slit lamp examination. Both anterior and posterior surfaces of Centerflex® showed typical reflections of the slit lamp beam with mild sheen possibly from sub spectral scattering of the wavelength of the light. The surface did not show any unusual pigmentation or implant precipitates. All lenses remained clear. In fact there is no reported case of biodegradation of the Rayacryl® material including opacification and calcification. This is an important landmark finding considering our extensive experience with this lens material which is now in the fifth year of use at Scarborough hospital and the number of lenses implanted is approximately 10,000.

2. The lens has been extensively used in all clinical conditions including uveitis, glaucoma, eyes with past glaucoma surgery, phacotrabeculectomy, diabetes, traumatic cataract, pseudoexfoliation syndrome. The Rayacryl® material has shown excellent biocompatibility in these conditions and the visual outcome has been very satisfactory.

3. There have been only two incidences of lens implant exchange, both for an unsatisfactory refractive outcome.

4. The lens has proved to be “very surgeon friendly”. It is very easy to handle and can be implanted through a 2.8mm sutureless corneal incision using the supplied single use, single piece injector. Its placement in the bag is atraumatic even when the anterior chamber is shallow or capsulorhexis is small or zonules are weak or there is a tear in the anterior capsule. It centres beautifully and remains very stable due to anti-vaulting haptics technology. This has contributed to excellent post operative refraction accuracy. In a 127 best case study (published in Eye 2002; 16:309-315), 87% were within +/- 0.5D of the target refraction and as many as 98% were within +/-1.0D of the target refraction. In another questionnaire based study, the incidence of dysphotopsia was found to be 1.9% with 98% reporting either “satisfied” or “very satisfied” with the visual outcome.

5. The incidence of posterior capsule opacification has been low. This is likely to reduce further with the C-flex® lens having 360° enhanced edge. Early reports have shown an excellent barrier effect of this edge to the centripetal growth of the epithelium not only at the optic edge but also at the haptic-optic junction.

There have recently been adverse press reports regarding biocompatibility of certain hydrophilic lens implants. We have found that no such biocompatibility problems existed with the Rayacryl® material. A minor drawback of posterior capsular opacification outweighs against the excellent handling characteristics and biocompatibility. With the new C-flex® design even this drawback now appears to have been significantly reduced.

The Rayacryl® material has proved to be very safe and biocompatible in our long term experience spanning nearly five years and involving nearly 10,000 eyes.

June 2004

Mr. Ashok Vyas FRCS (Ophth)
Mr. Peter Bacon FRCS (Ophth)

Department of Ophthalmology,
Scarborough Hospital,
Scarborough, UK