Light Adjustable Lens Success Relies on Partnership Between Surgeon and Patient
If you’re considering or scheduled for Light Adjustable Lens (LAL) cataract surgery, you may have come across discussions about something called “non-fixated light adjustment” or NFLA. This concept has created confusion among some patients. It is important to understand that the LAL light treatment is:
- Controlled by the Light Delivery Device (LDD) operator, who maintains alignment and focus throughout the process
- The LDD operator guides and supports the patient in their role during the light treatment, which is to steadily gaze at the flashing green light in the LDD and keep their eye still.
Optimizing the results of the LAL light treatment is the product of the partnership between the LDD operator and the patient. Working together ensures the light adjustment treatment is applied correctly to improve the patient’s vision with the LAL.
The Reality of Light Adjustable Lens (LAL) Light Treatments
Light Adjustable Lens technology represents an advanced approach to personalizing vision correction after cataract surgery through a series of light adjustment treatments to the lens. Unlike traditional fixed intraocular lenses, LALs are customized after implantation using specialized UV light to reshape the lens material to improve and refine its focusing power. However, achieving optimal results with this remarkable technology requires both surgical expertise and patient cooperation.
How LAL Light Adjustment Actually Works
During your light adjustment appointments, which typically take 60-90 minutes, you’ll work as a partner with your eye care provider. Here’s what the actual process involves:
Pre-Treatment Preparation: Your eye care team will assess your vision and discuss your specific goals in detail. This collaborative discussion drives the entire adjustment process and helps ensure your satisfaction with the results. Eye drops will be administered to dilate your pupils, which is an essential step in the process.
The Treatment Process: You’ll be positioned in front of the Light Delivery Device (LDD), the device your eye care provider uses to deliver precisely controlled UV light to your LAL. During this treatment, which lasts up to two minutes, you’ll be instructed to focus on a green blinking light and try to minimize movement.
Why Fixation Matters: Fixation by the patient ensures the light treatment is delivered as intended to the LAL. Your steady gaze helps ensure the light is delivered accurately to the intended areas of your lens. However, the LDD operator controls the targeting and delivery of the treatment with your cooperation in maintaining proper fixation and minimizing eye movement.
The LDD Operator’s Role: Precision and Expertise
Your eye care provider—whether an ophthalmologist or specially trained optometrist—brings extensive expertise to every LAL light treatment session. They are responsible for:
- Treatment Planning: Determining the optimal adjustment strategy based on your vision assessment and goals.
- Precise Targeting: The eye care provider’s microscope includes positioning guidance – literal crosshairs – to target the UV light treatment to exactly the right areas of the lens.
- Procedure Monitoring: Passive tracker technology alerts the eye care provider if the treatment area moves out of the target range.
- Progress Evaluation: Assessing your results and planning any additional adjustments needed.
The Light Delivery Device doesn’t deliver light treatments without the active participation of the LDD operator. The LDD operator follows several steps to ensure that the patient and LDD are ready for treatment. The eye that isn’t being treated is patched to help the patient focus on the blinking green fixation light, a contact lens with coupling gel is used to prevent blinking and minimize eye motion, and once the LDD operator initiates light treatment, they maintain alignment and focus by performing adjustments using the joystick while viewing a real-time image of the treatment.
Why Patient Cooperation is Essential
While the LDD operator handles the technical precision of the treatment, your role as a patient is equally important:
Active Fixation: Focusing on the green blinking light before the light treatment starts and minimizing eye movement while the treatment is delivered helps the LDD Operator ensure that the LAL light treatment is delivered to the intended location on your lens.
Communication: Throughout the treatment, your provider will guide you. If you need a break or experience discomfort, it’s important to communicate immediately.
Following Instructions: Proper preparation and UV protection before and after treatment are crucial for successful outcomes.
The Treatment Timeline
Most patients require 1 to 3 adjustment sessions followed by two mandatory “lock-in” treatments to permanently fix their customized vision correction. These appointments are typically scheduled 1 week apart, allowing time for your vision to stabilize and your brain to adapt between sessions.
During each session, your eye care team will:
- Assess your current vision
- Discuss any changes needed to meet your goals
- Perform the light treatment with your active participation
- Provide guidance for the recovery period following treatment
Focus and Fixation are Monitored by the LDD Operator
The concept of “non-fixated light adjustment” doesn’t take into account the essential role the LDD Operator plays in ensuring that light treatments are performed correctly. The precision required for optimal vision correction depends on both the LDD operator and the patient to ensure the proper application of the light adjustment treatment and avoid potentially compromising the results.
Your Role in Success
Remember that achieving your vision goals with Light Adjustable Lens technology is a collaborative process. Your eye care team brings the expertise, technology, and surgical skill, while you contribute by:
- Following all pre- and post-treatment instructions
- Communicating openly about your vision, experiences, and goals
- Following the instructions provided to you during LAL light treatments
- Being patient with the adjustment process
- Protecting your eyes from UV light as directed
Conclusion
Light Adjustable Lens technology offers a significant opportunity to customize your vision after cataract surgery, but it requires both professional skill and patient cooperation. There is no substitute for the careful collaboration between your eye care provider‘s technical skill and your active participation in the treatment process.
If you have questions about your upcoming LAL light treatments, don’t hesitate to discuss them with your eye care team. They’re your partners in achieving the best possible vision outcome, and understanding the process will help you feel confident and prepared for this innovative treatment.
Interested in learning more about Light Adjustable Lens technology? Check out the cataract surgery category of the RSC blog.
