Light Adjustable Lenses: Adjustable Intraocular Lens (IOL)
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Light adjustable lenses for cataract surgery or RLE are a modern intraocular lens type that can provide more precise vision adjustments.
What makes these lenses unique is that they can be adjusted after they’ve been implanted in your eye, using UV light to fine-tune the lens, hence the name light adjustable or light adjusting lenses. Like a monofocal lens, they provide only point of clear vision, but you can customize it to your liking.
You can even try out monovision (setting the power of one lens for distance vision and the other for near or intermediate) to get a wider range of spectacle-free clear vision. With other lenses, monovision is final and you make the choice before surgery. With the LAL, you can see how you like it before making your final choice.
What Are Light Adjustable Lenses?
The Light Adjustable Lens™ developed by RxSight is the first and only FDA-Approved lens that can be customized after cataract surgery. The LAL is made from a photosensitive silicone material. This material changes shape when exposed to specific wavelengths of ultraviolet (UV) light during a series of light treatments.
These light treatments will reshape your lens based on the visual correction needed to match your prescription. This means that your vision outcomes are totally customized to your own lifestyle and vision needs.
How Do Light Adjustable Lenses Work?
Light adjustable lenses work by using ultraviolet light to change their shape over a series of light treatments. This allows ophthalmologists to fine-tune the lens’s focus and customize vision correction to the patient’s lifestyle and vision needs.
During cataract surgery, the cloudy natural lens of the eye is removed and replaced with the LAL. The lens is implanted in the same way as traditional IOLs, but is made from a special photosensitive silicone material.
After the eye has healed (usually 3 weeks after surgery), you’ll begin a series of light treatments at your doctor’s office. On average, patients require 1-3 light treatments to achieve their desired vision outcome, with 2 extra treatments to “lock-in” the power of the lens. The light treatments are spaced out, with each session occurring about 3 days apart. Treatment sessions are brief, lasting just a few minutes per treatment.
The ophthalmologist uses a precise UV light device to adjust the lens. This UV light changes the molecular structure of the lens material, causing it to alter its shape.
The adjustments made with the UV light are aimed at refining the lens’ focus and correcting any remaining refractive errors (like nearsightedness, farsightedness, or astigmatism). With light adjustable lenses, patients can get the maximum level of vision correction possible.
What to Expect With Light Adjusting Lenses
Vision outcomes after cataract surgery largely depend on the type of IOL implant chosen to replace the natural lens of the eye. Patients with Light Adjustable Lenses are almost twice as likely to achieve 20/20 vision or better without glasses than patients who chose standard lens options.
While LALs require several visits to your ophthalmologist to unlock the true power of the lens, they provide custom vision outcomes, something no other lens can offer.
During the adjustment phase, you will need to wear UV protective glasses, as the shape of your LALs is not yet “locked-in”.
Costs of Light Adjustable Lenses
LALs are considered premium lenses, so they won’t be covered by insurance plans. The average cost of the LAL procedure ranges from $4,000 – $7,000 in total. Keep in mind that other factors can impact where you fall in this range, including the technology used during your cataract surgery and how many light treatment sessions you require to achieve your desired vision.
A study published in the Journal of Refractive Surgery showed that LALs, while more expensive than standard lenses, are a worthwhile investment for patients because of their enhanced vision outcomes.
The upfront cost of LALs is the only downside associated with this lens. However, our NVISION providers can work with you to set up a payment plan – contact us today to explore your options.
LALs vs. Traditional IOLs
Traditional IOLs are “fixed”: once they are implanted, they cannot be changed unless you undergo additional surgery. Light adjustable lenses, however, allow you to customize the lens to achieve your desired vision goals after the surgery. This means that you don’t need to make any decisions before your cataract surgery besides getting a light adjustable lens.
You can decide on what your best vision outcome is together with your surgeon once your eye has healed and you are ready to start your light treatment sessions. The treatment will change and mold the lens to achieve the best possible vision for you based on your preferences, lifestyle and eye needs.
LAL vs Monofocal Lenses
The LAL is a premium version a monofocal lens that can be customizable. It offers the same clarity of vision as monofocals, but allows for very precise fine-tuning. You can also experiment with your ideal vision range before you settling on your desired outcome, which you cannot do with any other lens, monofocal or not.
LAL vs Multifocal, Accommodating and EDOF Lenses
Multifocal IOLs, Extended Depth of Focus (EDOF) IOLs and Accommodating Lenses are premium lenses that provide a wider range of clear vision (near, intermediate and distance). LALs provide one customizable focal point of clear vision, so patients will most likely need glasses to perform certin tasks, as vision won’t be continuous. However, there is a way to obtian a wider range of vision with the LAL (and its newer model, the LAL+) by doing monovision surgery. This way, the lens provides both extreme clarity of vision and a higher degree of spectacle independence, though patients might still need reading glasses for extremely fine print.
LAL vs Toric Lenses
Intraocular lenses don’t normally address astigmatism by themselves, but do so by incorporating a special shape into the lens design. This shape is meant to correct for the unneven shape of the cornea that causes astigmatism. IOLs that incorporate this technology are called toric lenses, and they can be monofocal, multifocal, EDOF or accommodating. The LAL lens is not toric by default,, but it can be correct astigmatism by shaping the lens into the right “toric” shape during the light treatment phase. This means that the lens offers precise astigmatism correction.
Benefits of Light Adjustable Lenses
- Customizable Vision: LALs allow your eye doctor to fine-tune and customize your prescription after cataract surgery to achieve the best possible vision for you.
- Non-Invasive Adjustments: Light treatments for LALs are quick and non-invasive, lasting approximately 90 seconds per eye.
- Flexibility: With LALs, you can try out different lens powers and vision corrections after surgery before the final lens shape is locked in. This gives you the flexibility to optimize your vision.
- Excellent Outcomes: Studies show LALs can provide very accurate vision results, with most patients achieving 20/20 or better uncorrected vision after the adjustments.
- Helpful for Complex Cases: LALs are particularly useful for patients with astigmatism or those who have had previous eye surgery, as precisely measuring the right lens power can be challenging.
- Safety Net with Room for Error: These lenses provide a safety net by allowing adjustments post-implantation, reducing the likelihood of additional surgeries.
While traditional IOLs have served as a reliable solution for vision correction, Light Adjustable Lenses represent a significant advancement in the field, offering unparalleled customization, adaptability, and precision in achieving optimal visual outcomes.
LAL vs. LAL+
The LAL+ is a newer model of the LAL developed by the same manufacturer, RxSight.The LAL+ works the same way as the LAL, but it has a specially designed front surface that gradually increases the lens’s power in the center. This unique optical feature enhances the depth of focus even before any light treatments.
The added depth of focus is great for patients who want to do mini-monovision procedure, where one eye is set for distance vision, and the other for intermediate vision. The eye set for distance will have some intermediate range of vision, and the eye set for intermediate will have some range for near and distance vision. With this alternative, not only do you get the excellent vision results, but are more likely to achieve spectacle independence, though you might still needs glasses for very fine print.
Where Can You Get Light Adjustable Lenses for Cataract Surgery?
Since FDA approval for the U.S. market, you can get light adjustable cataract lenses implanted at most facilities capable of performing other premium IOL procedures. At NVISION, we have a team of surgeons with extensive expertise in LAL implants. Our network serves patients across the USA. Get in touch with our team to discuss your upcoming surgery.
Light Adjustable Lenses FAQs
What is a light adjustable lens?
A light adjustable lens is a small ocular lens that can adjust under UV light. Once a patient has had the necessary adjustments, a doctor provides one final treatment that “locks” the shape of the lens.
Are light adjustable lenses good?
Data suggests light adjustable lenses provide a meaningful improvement to the vision of cataract patients, more so than standard IOLS, which sometimes provide less vision correction than a patient might desire. While a light adjustable lens does not necessarily provide “perfect” vision, it is a valid treatment for cataract patients and worth discussing with your doctor.
When Did Light Adjustable Lenses Come Out?
The Light Adjustable Lens (LAL) from RxSight was approved by the FDA in 2017 and became commercially available in the United States that year.
Where Are Light Adjustable Lenses Allowed?
Since FDA approval, light adjustable lenses can be implanted at most facilities in the US capable of performing premium IOL procedures for cataract surgery.
References
- FDA Approves First Implanted Lens That Can Be Adjusted After Cataract Surgery to Improve Vision Without Eyeglasses in Some Patients. (November 2017). U.S. Food and Drug Administration.
- Introducing the Light Adjustable Lens™ from RxSight®. RxSight.
- IOL Implants: Lens Replacement After Cataracts. (April 2021). American Academy of Ophthalmology.
- Medical Coverage Policy | Multifocal / Accommodating Intraocular Lens (IOL). (November 2014). Blue Cross Blue Shield of Rhode Island.
- Patient-Reported Outcomes in Intraocular Lens Labeling. (November 2017). U.S. Food and Drug Administration.
- Review of Ophthalmology: Annual IOL Issue, January 2018. (January 2018). Review of Ophthalmology.
- Summary of Safety and Effectiveness Data (SSED). (November 2017). U.S. Food and Drug Administration.
- Study Identifies Clear Positive Economic Impact of the RxSight Light Adjustable Lens® (LAL®) on Practice Revenues, Margins, and Outcomes. (June 2022). LinkedIn.
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