What Makes Light Adjustable Lens Different Than Other Cataract Surgeries?

Cataract surgery is one of the most common and successful procedures performed in the United States every year. It involves the removal of your cataract (a clouding or yellowing of the normally clear lens inside the eye) and placement of an intraocular lens (IOL). With traditional IOLs, your doctor measures your eye to get the correct lens strength to achieve your vision goals, but postoperative changes in the eye can make the new lens focus light imprecisely. Once the IOL has been implanted, there are limited options to adjust the lens power. However, the Light Adjustable Lens (LAL) from RxSight is the first and only IOL that can be adjusted after implantation and healing to make the focus precise. This optimization is done by your eye doctor through a series of light treatment procedures that take only a few minutes each. With this ability to modify or adjust a patient’s vision easily after surgery, the use of Light Adjustable Lenses allows our surgeons to deliver incredibly high levels of visual acuity without glasses and the ability to personalize visual results based on individual patient preferences. At Hill Vision Services, our team of experienced ophthalmologists is committed to providing the best possible eye care. That’s why we are one of the few doctors in the St. Louis area now offering the Light Adjustable Lens. Contact us today for this new, advanced solution.

The Light Adjustable Lens Procedure

If you select the Light Adjustable Lens, the first step is to have your cataract safely removed and the adjustable IOL implanted. The cataract removal and IOL implantation procedure is the same as if you selected a non-adjustable IOL. To customize your vision, you will preview and compare possible vision outcomes with your doctor based on your unique preferences and lifestyle requirements before selecting a prescription for your adjustable lens. After your LAL has been implanted in your eye, it is adjusted to deliver the customized vision you desire. This means that there are two major differences following your surgery as compared to a non-adjustable IOL: required wear of UV protective glasses and completion of light treatments. UV Protective Glasses Exposure to indoor and outdoor sources of UV light can cause uncontrolled changes to the LAL. In order to prevent this, special UV-protective glasses must be worn immediately following surgery during all waking hours (from the time of lens implantation until after the last light treatment is completed). Your protective glasses may be removed when sleeping and may be temporarily removed when showering, washing your face, or applying eye drops as long as you are not exposed to direct sunlight. Light Treatments The Light Adjustable Lens is made of a special photosensitive material that can be precisely adjusted by your doctor after implantation via targeted ultraviolet (UV) light. These light treatments are delivered in your doctor’s office with the Light Delivery Device (LDD) after your eye has healed. Each light treatment lasts about 90 seconds and usually, 3 to 5 treatments are required following cataract surgery. Each is separated by three days, to “lock in” the new strength. The process for adjusting the LAL is:

1. Adjustment Beam - Light from the RxSight LDD is non-invasively directed by your surgeon to the LAL.
2. Photopolymerization - Macromers in the path of the light are photopolymerized.
3. Diffusion and Power Change - Unpolymerized macromers move into the exposed area, causing precise shape and power change.
4. Lock-In Beam - The entire lens is exposed to light to polymerize all the remaining macromers.
5. Final Result - The outcome is a precise change in the lens power to match the patient’s individual prescription.

UV-Blocking Glasses FAQs

Why Do I Have To Wear the UV-blocking Glasses?

The UV-blocking glasses provided to you protect the Light Adjustable Lens from UV light sources other than the LDD that your doctor will use to optimize your vision. Exposing the LAL to other UV light sources will potentially change the lens correction in an uncontrolled manner. If you do not wear the provided UV-blocking glasses, your vision may not improve or it could get worse. If this happens, the LAL may have to be removed and replaced with a new lens to improve your vision.

How Long Do I Have To Wear the UV-blocking Glasses?

The UV-blocking glasses must be worn at all times until your eye doctor tells you that you no longer need to wear them (usually 24 hours after your final light treatment). Total wear is typically about six weeks in duration, however, this may vary depending on the number of light treatments delivered.

Can I Wear My Regular Sunglasses That Have UV Protection?

No, you must wear the UV-blocking glasses provided to you. These glasses have a special protective coating that no other glasses have.

Which Pair of UV-blocking Glasses Should I Wear if It Is Dark Outside?

You must wear the dark pair of UV-blocking glasses during daylight hours, even if it is overcast. The clear pair can only be worn outside after sundown.

What Should I Do if I Forget To Wear My UV-Blocking Glasses?

It’s important that you try not to forget to wear your UV-blocking glasses. However, if you do forget, please put them on as soon as you remember. Note how long you didn’t have the glasses on and the light conditions during this time, then contact your eye doctor immediately.

What Happens if I Lose or Break My UV-Blocking Glasses?

If one of your two pairs of UV-blocking glasses is lost, damaged, or unwearable, continue to wear the other pair and contact your doctor as soon as possible. If both are lost or damaged, wear the darkest sunglasses you have and contact your doctor immediately.

Light Treatment FAQs

Are the Light Treatments Painful?

No, numbing drops are applied to your eyes for the treatments. You may feel some mild pressure or discomfort; however, the light treatments should not be painful.

What Should I Expect After Each Light Treatment?

Your vision may be blurry immediately after each treatment due to a gel used during application of the light treatment, but this should resolve quickly. Your eye may be dilated for the treatment, which may require you to wear tinted glasses for a few hours. It may take 24-72 hours after each light treatment to notice an improvement in vision. The light from the LDD may also cause a temporary or long-lasting pink or red afterimage, which is common with a light source directed to the eye. This tinge in your vision is especially noticeable on things that normally look white.

Contact Us for Light Adjustable Lens Surgery

Our eye doctors and the entire team at Hill Vision Services are dedicated to helping our patients achieve the sharpest and clearest vision possible. Request an appointment with one of our eye care experts in the St. Louis area to help determine if LAL cataract surgery is right for you.