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Light Adjustable Lens: A Revolution in Cataract Surgery

light adjustable lens
CONTENTS

Cataract surgery has come a long way, with advancements in technology providing better outcomes for patients. One such innovation is the Light Adjustable Lens (LAL) from RxSight, a game-changer in the field of ophthalmology. This article will delve into what the Light Adjustable Lens is, how it works, who can benefit from it, and the advantages it offers.

Introduction to Light Adjustable Lens

The Light Adjustable Lens (LAL) is a unique type of artificial intraocular lens (IOL) used in cataract surgery. Unlike traditional IOLs, the LAL is made of a special photosensitive material that allows the power of the lens to be adjusted after it has been implanted in the eye. This adjustment is made in response to ultraviolet light, applied in a non-invasive procedure 2-4 weeks after the initial surgery.

The LAL shape and its focusing characteristics can be changed after implantation in the eye using an office-based ultra-violet (UV) light source called the Light Delivery Device (LDD).

Light Adjustable Lens (LAL) changes after UV light treatments with Light Delivery System (LDD)

How Does the Light Adjustable Lens Work?

The lens offers the unique ability to adjust and preview your vision after your cataract surgery. After the lens is implanted, your eye doctor will use the LDD to shine this light onto your lens, causing the lens to change shape and power. This allows your eye doctor to fine-tune your vision to your specific needs, potentially reducing the need for glasses after surgery.

The process typically involves the following steps:

  1. Cataract removal: Traditional cataract surgery is performed where the cloudy natural lens is removed leaving behind a clear capsule for the IOL.
  2. Lens Implantation: The LAL is implanted in your eye during cataract surgery, replacing the cloudy lens.
  3. Initial Recovery: You’ll have a recovery period to allow your eye to heal from the surgery.
  4. Lens Adjustment: Your doctor will use LDD to adjust the lens, fine-tuning your vision.
  5. Final Light Treatment: Once the desired vision is achieved, your doctor will use a different wavelength of light to lock in the adjustments, preventing further changes.

The LDD light treatment procedures will begin 17-24 days after the LAL has been implanted. You will undergo one to three adjustment light treatments over a period of 1-2 weeks, each lasting from 40 seconds to 2 ½ minutes, depending upon the amount of correction needed after surgery.

Who is a Good Candidate for Light Adjustable Lens?

The Light Adjustable Lens can be a great option for many patients undergoing cataract surgery.

It’s particularly beneficial for patients who have specific vision goals or who have had previous refractive surgery, such as LASIK or PRK. Predicting the outcome of cataract surgery is challenging in these patients and the LAL provides a way to reduce this challenge.

Ideal candidates for the LAL typically:

  • Have a goal of reducing dependency on glasses
  • Are able to return for 3 to 5 additional appointments
  • Are able to comply with wearing UV protective glasses for several weeks after surgery

However, not all patients are candidates for a LAL. Your doctor will evaluate your eye health, lifestyle, and vision goals to determine if this lens is a good fit for you.

Who is a Bad Candidate for Light Adjustable Lens?

While the Light Adjustable Lens offers a unique solution for vision correction after cataract surgery, it’s not suitable for everyone.

The LAL and post-operative LDD light treatments are not recommended if:

  • your pupils do not dilate well
  • you are taking medications that may increase sensitivity to UV light
  • you are taking a medication that is considered harmful to the retina
  • you have a history of herpes eye infection
  • you have a history of uncontrollable eye movements (nystagmus)
  • you are unable to comply with the post-operative schedule of visits and LDD light treatments
  • you are unable to wear the special UV protective eyewear during the period specified

It’s crucial to have a detailed discussion with your healthcare provider about your medical history and lifestyle to determine if the Light Adjustable Lens is the right choice for you.

Benefits of Light Adjustable Lenses

The potential benefits of the lens are numerous. Most patients undergoing cataract surgery to remove a cloudy lens with implantation of any IOL will experience better far vision without glasses after the procedure. For patients with astigmatism before surgery, the potential additional benefit of the LAL is that the shape and focusing characteristics can be changed using the LDD to further improve your vision without glasses after surgery.

Some of the key benefits include:

  • Customized Vision: LAL allows for post-operative adjustments, meaning your vision can be fine-tuned to your specific needs after the surgery, including treating astigmatism.
  • Reduced Dependence on Glasses: By allowing for these adjustments, LAL can potentially reduce your dependence on glasses or contact lenses after surgery.
  • Improved Quality of Vision: Many patients report improved quality of vision after the adjustment period, including sharper vision and better contrast sensitivity.

More patients with LAL had 20/20 vision without glasses 6 months after their surgery compared to patients with standard IOLs. The amount of astigmatism that LAL patients had was also less.

Drawbacks of Light Adjustable Lens

While the Light Adjustable Lens offers many benefits, there are also some considerations to keep in mind.

Possible adverse events and complications due to the use of UV light from the LDD include loss of vision, a temporary or long-lasting change to your color vision, a temporary or long-lasting pink or red tinge to your vision, and activation of a previously undiagnosed herpes eye infection.

Taken directly from the SUMMARY OF SAFETY AND EFFECTIVENESS DATA (SSED):

“One subject experienced a retinal phototoxic injury that was determined to be caused by a faulty filter within the UV source of the LDD. Corrective action was taken to ensure that defective filters were not released to the market. “

According to the document, this patient had some vision loss that recovered to near 20/20 at about 5 months after the surgery. Eventually, the LAL was removed and replaced with a standard monofocal IOL.

And:

“Following the initial light treatment, one subject experienced a reactivation of previously undiagnosed herpes simplex virus (HSV). Following anti-HSV therapy, the subject’s condition improved and remaining light treatments were administered.”

This patient recovered their vision back to 20/20 at about 1 year from the surgery.

Other risks include reactions to medicines or anesthesia, redness, scratchiness of the eye, sensitivity to light, bleeding, inflammation, infection, tissue damage, tissue swelling of the front or back of the eye, an increase in eye pressure, or damage to the parts of the eye where the IOL is placed. These reactions are not specific to LAL and can occur with any lens implant surgery.

Patient Experiences and Reviews

Patient experiences and reviews of the Light Adjustable Lens are generally positive. Many patients report improved vision and a reduced dependence on glasses or contact lenses.

However, it’s important to remember that individual experiences can vary, and what works well for one person may not work as well for another. It’s always best to discuss your specific needs and expectations with your doctor to ensure that the Light Adjustable Lens is the right choice for you.

Conclusion

The Light Adjustable Lens represents a significant advancement in cataract surgery, offering the potential for customized vision correction that can be fine-tuned after the surgery. However, as with any medical procedure, it’s important to understand the potential benefits, risks, and contraindications.

Always consult with your healthcare provider to make an informed decision about whether the Light Adjustable Lens is the right choice for your specific needs and circumstances.

Here is a link directly to the Patient Information Brochure PDF for more information. If you are interested in more technical information, read through the Professional Use Information PDF directed at health care professionals.

Remember, the best outcomes in cataract surgery are achieved when you and your doctor work together to choose the treatment option that is best for you. From the many different implant options, the best implant is the one that meets your specific needs.

FAQs about Light Adjustable Lenses

  • Are Light Adjustable Lenses worth it?

    Light Adjustable Lenses can be a great option for individuals who want to fine-tune their vision after cataract surgery. They offer the potential for customized vision correction and can potentially reduce dependence on glasses or contact lenses. Twice as many patients were 20/20 without glasses with the LAL compared to patients with a standard lens.

  • How long does a Light Adjustable Lens last?

    Once the adjustments to the Light Adjustable Lens have been made and locked in, the lens is designed to last a lifetime. It does not need to be replaced unless complications occur.

  • Can a Light Adjustable Lens be removed?

    While it is technically possible to remove a Light Adjustable Lens, it is generally not recommended unless complications occur. The lens is designed to remain in the eye permanently.

  • What is the cost of the Light Adjustable Lens?

    The out of pocket cost currently ranges between $4,000 – $6,000 per eye. Insurance does not currently cover this lens implant with cataract surgery.