The Light-Adjustable Lens

The light adjustable lens, approved by the FDA in 2017, is an advanced technology intraocular lens that can be adjusted to refine your vision several weeks after surgery.  

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This can be important, because the results you get from your cataract surgery are not entirely predictable.  When predicting the refractive outcome of your cataract surgery, your surgeon is like a professional golfer hitting a putt.  Sometimes the ball goes in the hole.  Sometimes it ends up near the hole.   

 

The refractive outcome of your cataract surgery is just like this.   Your vision may be a little different than planned.

 

It takes some time for the exact result of your cataract surgery to stabilize- three weeks or more in many cases.  It can take take substantially longer if you have had refractive surgery like LASIK.   So your surgeon doesn’t know where their putt ended up until about three weeks or more after surgery.

 

This is where the light-adjustable lens comes in.  Weeks after surgery, when your refraction has stabilized, your surgeon will perform adjustments in the lens using a special light attached to a slit lamp in the exam room.   It’s like a second putt.

 

The light adjustable lens is not a multifocal or extended depth of focus lens.  Think of it as a single focus lens that can be targeted a little more precisely.  

 

Advantages

 

Accurate refractive results.  Many surgeons consider the light adjustable lens to be especially well suited for the more complex refractive issues in eyes that have had LASIK, but can also refine the results in most eyes, and treat astigmatism. 

 

Disadvantages

 

You need to wear UV glasses until the treatment is finished

You need to wear UV protective glasses all waking hours until your surgeon performs the final adjustment and “locks” the lens in.  After that, the lens is no longer adjustable and you no longer have to wear UV protective glasses.

 

Extra time commitment

Choosing light adjustable technology is a commitment for both you and your surgical team.  You will have more post operative visits, and more dilations.  You will require one or more specialized light treatments after surgery.  Although the treatments are quite easy for you and only take a minute or two, you will also need to be refracted and dilated, so each visit might take a while.  

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Cost

The light adjustable lens, like other advanced technology lenses, is something you will pay for out of pocket.

 

Light-adjustable lens technology is very new in the United States.  It has exciting potential.  How much it affects the delivery of cataract surgery in the US remains to be seen.