The Light-Adjustable Lens

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

This adjustment can be important, because the results you get from your cataract surgery are not entirely predictable. Your surgeon is like a professional golfer hitting a putt. Sometimes the ball goes in the hole. Sometimes it misses by a little bit.

Cataract surgery is no different. Your vision may come out a little different than planned.

It takes three weeks or more for the eye to heal and your refraction to stabilize, and substantially longer if you have had refractive surgery like LASIK. So your surgeon doesn’t know where their putt ended up until at least three weeks after surgery.

This is where the light-adjustable lens becomes useful. The lens is placed inside your eye during cataract surgery, instead of the standard artificial lens. Weeks after surgery, when your refraction has stabilized, your surgeon will use a special light attached to a slit lamp in the exam room to adjust the lens. It’s like the surgeon gets a second putt.

The light adjustable lens is not a multifocal or extended depth of focus lens. 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 it has the potential to 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 for several weeks 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.

There is an extra time commitment

Choosing light adjustable technology is a commitment for both you and your surgical team. You 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.

Cost

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

Conclusion

Cataract surgery is already accurate enough to deliver outstanding vision after cataract surgery. Light-adjustable lens technology has the potential to take the results to a slightly higher plane. It may be especially useful if you had LASIK in the past.

This technology has been approved in Europe and Mexico for more than a decade. It 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.

Christopher A. Kuntz. M.D is a cataract surgeon from Seattle, Washington. He is the author of the website www.cataractsurgerydesign.com, which teaches you what you need to know to get the most out of your cataract surgery.

After 20 years performing cataract surgery, Dr. Kuntz is now focused on patient education. He has no financial interest in the devices or topics discussed in this post.