An Australian ophthalmologist has found that for most of what he sees in his clinic and surgery, the British intraocular lens manufacturer has designed a solution that improves his patients’ vision and well-being.
There’s a modern expression that suggests whatever you might want or need, there’s probably an app for that.
Eye surgeon Dr Justin Sherwin believes there is an intraocular lens (IOL) equivalent. He notes that IOL selection remains individualised, and he routinely uses a range of IOL platforms depending on patient anatomy, visual goals, and ocular comorbidities.
And now he has the data to back up that confidence.
Dr Sherwin has a special interest in cataract, refractive and glaucoma surgery. He is director of Peninsula Eye Centre and practices at Bayside Eye Specialists, Vista Eyes Laser Clinic, and the Royal Victorian Eye and Ear Hospital, with an honorary appointment at Vision Australia.
He also serves as vice-president of the Australian Society of Ophthalmologists, lectures nationally and internationally, and sits on multiple industry advisory boards.
He also has a keen interest in learning about new technology and ophthalmic advances.
As an early adopter who works across multiple IOL platforms, he has followed the development of several advanced lens technologies closely, including those designed by British IOL manufacturer Rayner.
In particular, he has closely followed the development of the RayOne EMV and Galaxy IOLs.
He regularly engages with peers in Australia and internationally through clinical collaboration, research activity, education, and ongoing dialogue with key opinion leaders.
“I looked more closely at the emerging evidence of the Galaxy IOL, particularly the pivotal multicentre trial published in the Journal of Refractive Surgery,” he says.
Encouraged by what he saw in both the published data and early clinical experience, he has implanted more than 100 Galaxy lenses since the IOL became available in Australia last year.
That’s helped him build a greater understanding about which patients are better suited to either the EMV or the Galaxy, or perhaps one of Rayner’s other IOLs, including its standard monofocal, toric and Sulcoflex pseudophakic supplementary IOL products.
“Rayner has a wide range of products that can address a broad range of refractive needs, during cataract and lens-based refractive surgery,” he says.
That includes the EMV IOL, developed in partnership with Australian ophthalmologist Professor Graham Barrett.
EMV works by increasing positive spherical aberration to gently stretch the patient’s range of vision.
The dominant eye is generally set for plano, with the non-dominant eye given a modest, myopic target (micro-monovision).
“In appropriately selected patients, this strategy works extremely well, particularly for those who place a high value on intermediate vision and functional near vision,” says Dr Sherwin.
These patients are not as focused as others on complete spectacle independence and may be comfortable with reading glasses for near work but seek better intermediate vision to help with using their phones, computers and other devices.
“One of the key strengths of the EMV lens is its very monofocal-like side-effect profile, particularly with respect to glare and halos,” he says.
“Presbyopia-correcting IOLs perform best in patients with otherwise healthy eyes, including an excellent tear film, regular astigmatism, low levels of higher-order aberrations, and healthy corneas, optic discs and maculae.”
He also favors the EMV in myopic patients and in those who are physiologically suited to, or have previously tolerated, monovision through contact lens wear.
“Contact lens trials can also help to determine who would be suitable for this mono-vision approach.”
He prefers the Galaxy IOL for those patients seeking complete spectacle independence.
The product, designed using a proprietary AI engine trained on patient outcomes and the expertise of Brazilian ophthalmologist Dr João Lyra, employs spiral optics technology that distributes light evenly across the retina.
“It is particularly well suited to patients seeking a full functional range of vision with a high likelihood of spectacle independence, while still prioritising visual quality.”
Many such patients are also conscious of the glare and halos associated with some earlier diffractive multifocal IOL designs.
“Early clinical trial data suggest that the incidence of symptomatic, visually disturbing dysphotopia is reduced compared with earlier diffractive multifocal designs, which increases surgeon confidence in delivering consistent outcomes across the visual range.”
Dr Sherwin says while there is a Rayner IOL for practically every patient, there are some for whom even the power of an EMV or Galaxy may not be optimal.
“The potential for independence at intermediate and near distances is closely linked to the degree of visual limitation imposed by underlying pathology,” he says.
“In patients with significant ocular comorbidities, such as moderate to severe glaucoma or age-related macular degeneration, alternative IOL strategies may be more appropriate.”
However, for patients without significant vision-limiting comorbidities, he is confident that Rayner offers suitable IOL options to improve visual outcomes.
He emphasises that these views reflect his own early real-world experience and are consistent with results reported in the published Galaxy clinical trial.
Dr Sherwin has just completed an early real-world audit of his first 80 Galaxy patients. While the dataset is relatively small and observational in nature, it provides useful early insight into outcomes in routine clinical practice. The numbers involve patients who either had cataract surgery or refractive lens exchange.
More than 80% of those patients had 6/6 or better intermediate-distance vision – “very good vision for seeing computer or phone screens and car dashboards and the likes”.
At near-vision – 40cm – the mean was N5, with 84% N5 or better, and 93% of the patients surveyed were within 0.50 D of their refractive target.
“There was a high likelihood of functional spectacle independence, acknowledging that individual visual demands and expectations vary.”
He says those results are “promising and very reassuring”.
Just as important was the figure zero – the number of explants he had done.
Dr Sherwin notes he did not formally assess dysphotopia in the survey, but neither had any of his patients complained about those, despite some of his clients often requiring plenty of night-time driving over considerable distances.
And he has also had success using the Galaxy on patients who have had laser refractive surgery.
“The Galaxy IOL has proven relatively forgiving from that point of view, but careful patient selection is key.”
He has also become more comfortable with the Galaxy IOL’s hydrophilic material, an area that has traditionally raised caution among some surgeons.
“Concerns around hydrophilic lenses largely relate to historical reports of secondary calcification, but it’s important to understand the context in which those events occur,” he says.
Secondary opacification following exposure to intraocular gas or air — most commonly after retinal or corneal surgeries — is a recognised but very uncommon phenomenon. Importantly, primary in-the-bag hydrophilic IOL opacification after routine cataract surgery is exceedingly rare.
“With modern IOL designs and appropriate patient selection, this has not been a clinically meaningful issue in my experience,” Dr Sherwin says.
He adds that recent data presented by researchers from St Thomas’ Hospital, London, at the 2025 ESCRS Congress show modern hydrophilic and hydrophobic IOL materials to be clinically and statistically equivalent in rates of posterior capsular opacification.
That, along with his research and his own patients’ feedback, has Dr Sherwin picking a surge in the Galaxy’s use once the product is included in Australia’s Prostheses List (PL), which he believes could come early in the new year.
“My cohort has been limited to people without private health insurance, so only uninsured cataract surgery patients and refractive lens exchange patients,” he says.
He notes that appropriate patient selection, counselling, and expectation management remain central, regardless of IOL platform.
“Once Galaxy is listed on the PL in Australia, I expect we’ll see a significant increase in uptake, particularly among surgeons looking for a full range of vision options with excellent visual quality.”
