What is a Light Adjustable Lens for Cataract Surgery?

If you’re preparing for cataract surgery, you may have heard about the Light Adjustable Lens (LAL). This advanced lens is the latest vision correcting technology that cataract surgeons can offer to help patients reduce or eliminate their need for glasses and contact lenses to see well. If you are weighing your lens options for cataract surgery, this article explains what Light Adjustable Lens technology is, how it works, and its performance outcomes, giving more cataract patients superb vision without glasses or contact lenses.

Understanding Cataracts and Traditional Lens Implants

When you have a cataract, the natural lens in your eye becomes cloudy, making it difficult to see well and can ultimately lead to vision loss. During cataract surgery, this cloudy lens is removed and replaced with an artificial lens called an intraocular lens (IOL). With traditional vision-correcting IOLs, your cataract surgeon selects a specific lens power before your surgery, which can include vision prescriptions to help reduce or eliminate your need for glasses or contacts after surgery. Your final vision outcome depends on how your eye heals and how the lens settles in your eye.

What Makes a Light Adjustable Lens Different?

The Light Adjustable Lens is made of a special material that can be modified using UV light treatments after it’s implanted in your eye, allowing you to make decisions about your vision after surgery. After you have healed from the procedure and can experience how you see, rather than before surgery, when your cataract surgeon must predict your outcome, adjustments to the lens can be made to improve its focusing power to suit your vision needs.

UV Protection Requirements for Light Adjustable Lenses

Because the LAL material is UV sensitive, from the time of surgery until 24 hours after your final lock-in treatment, you must wear special UV protective glasses during all waking hours. These glasses (you’ll receive three pairs—tinted, clear, and clear readers) protect your lens from environmental UV light that could cause unwanted changes to the lens.

The Three Phases of LAL Treatment

Phase 1: Postoperative Healing

• Your vision may be blurry as your eye heals
• Follow your doctor’s instructions for eye drops to support the healing process
• Wear your UV protective glasses to maintain the Light Adjustable Lens’ integrity
• Attend follow-up appointments to check your healing progress

Phase 2: Vision Customization

• Assess your post op vision and discuss your vision goals with your doctor
• Undergo light treatments to customize the shape and power of the lens to suit your vision needs. Typically, patients get between 1 – 3 UV light treatments to achieve their desired visual outcome.
• Test your vision in different real-life situations, making note of any need for refinement.

Phase 3: Lock-In

• Once you are satisfied with your vision correction, two lock-in treatments are needed to make your vision adjustments permanent
• You can stop wearing UV protective glasses 24 hours after the final lock-in
• Your vision is now set at your customized level

How well do the Light Adjustable Lenses work?

The clinical study submitted to the U.S. Food and Drug Administration found that cataract surgery with LAL technology was both safe and effective for those who are good candidates. The study included 403 patients undergoing cataract surgery with Light Adjustable Lenses and found:

• More than 70 percent of nearsighted patients could see 20/20 or better without glasses after LAL surgery, and more than 99 percent could see 20/40 or better.
• Although 1 in 4 patients had astigmatism prescriptions below the approved range, more than 74 percent of patients (nearly 100 percent of the treatable prescription population) had their astigmatism reduced following LAL surgery.
• Adverse events were very rare, affecting less than 1 percent of study participants, all of whom received additional care resulting in good vision.

Who Is a Good Candidate?

Candidates for Light Adjustable Lens technology are generally the same as those for cataract surgery, however, there are some important differences. You may be a good candidate for the Light Adjustable Lens if you:

• Have a cataract
• Have astigmatism of at least 0.75 diopters
• Are between 40 – 80 years old and able to maintain a steady fixed gaze
• Have healthy eyes (except for cataracts) with no history of herpes eye infection or macular disease
• Are not taking medications that increase sensitivity to UV light (e.g., tamoxifen)
• Are willing to follow the treatment schedule and wear UV protective glasses
• Have pupils that dilate to 6 mm or more

Benefits of the Light Adjustable Lens

• Allows vision adjustment after surgery when your eye has healed
• Can correct astigmatism as low as 0.50 diopters
• Experience your vision before it’s permanently set
• Reduces the chances of needing glasses for distance vision
• Helps account for healing changes that can affect vision outcomes

Limitations of the Light Adjustable Lens

• The LAL does not adjust to reduce the need for reading glasses
• You must commit to the full treatment schedule
• You must wear UV protective eyewear during all waking hours up until 24 hours after your final lock-in treatment. Depending upon the number of light adjustment treatments required to achieve your desired visual outcome, you may need to wear UV protective eyewear for several weeks.

Making Your Decision

Choosing the right lens for cataract surgery is an important decision. Discuss your lifestyle, vision goals, and medical history with your cataract surgeon to determine if the Light Adjustable Lens is appropriate for you. In our next article, we go into depth about what to expect during the vision customization phase of the Light Adjustable Lens, which is different than cataract surgery with other vision correcting IOLs.

Need to find a refractive cataract surgeon? Check out RSC’s surgeon finder and learn more about vision-correcting IOL technology, including the Light Adjustable Lens.