Is there any experience here with the light adjustable lens (LAL)?

rwbil assia99778 · 2024-02-13T16:30+00:00

This IOL requires special equipment so only a few Opthmalogist implant it. From the little I know in the US it is only being used as a monofocal, but the Codet Vision Institute is also trying out its ability in other configurations. You could call the Codet Institue and ask them about that, but I imagine when the IOL is configured other than a monofocal, one would get the same dysphotopsias associated with other defractive IOLs.

The big advantage is the ability to make post operatively adjustments and nail Plano or whatever your goal is.

If you decide to do monovision you would have the ability to accurately adjust the power the way you want.

Now what would be "Cool" is if they could configure the IOL for EDOF or as a Trifocal and then if you don't like it post operatively change it back to a monofocal.

RonAKA assia99778 · 2021-03-12T16:59+00:00

I have no experience with them, and just have a standard monofocal lens. I have looked into them a bit. My conclusion is that they are not a presbyopia correcting lens, just a one distance monofocal that can be adjusted somewhat after implantation. I believe there is a limited time that they can be adjusted and then they become fixed. As far as I can see the only benefit is the ability to correct the power of the lens when the surgeon has miscalculated what power is needed. There could be some circumstances (high far sighted eye perhaps) where it is difficult to measure and calculate the required power where it could be of significant benefit. But on the other hand if the surgeon nails it for power, then it would seem to have no value at all over a standard lens. One would have to look at it in a lot more detail to see if there are any negatives, like the power drifting over time. I just have not investigated it. My second lens is most likely to be another standard monofocal in a monovision configuration.

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Review of Ophthalmology does an annual survey of cataract surgeons to get some information about what is actually being used. I suspect it is a US surgeon survey mainly, so will reflect the lenses being used in the US. You could google the title of the article below for more detail. What I saw in it was the 6-7% of surgeons were considering the use of a light adjusting lens, but they gave no information on how many are actually using it. It is an interesting read to see what lenses surgeons are actually using of the various types of lenses on the market.

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Review of Ophthalmology 15 JANUARY 2021 IOL Survey: New lenses turn surgeons’ heads

banterer assia99778 · 2024-02-13T16:45+00:00

I popped in here to see what others were saying about their experience with the LAL but it looks like I'm going to be the one sharing my experience and clearing up a few misconceptions.

First things first—I just had my left eye done with the RxLAL this past Tuesday. I'm 63 and had cataract in both eyes. I had it done in Cape Coral by a surgeon who was recommended to me by another cataract surgeon who got the same lenses put in 10 days prior to emailing me. So he is probably about 3 weeks in and LOVES them. He says that he has HD vision and I cannot fault him on his description.

I am not familiar with all the meanings of the different terms (like Presbyopia which is apparently farsightedness). I have always been nearsighted. Here is what I can tell you about my experience thus far.

Like everyone else seems to say about most cataract procedures, it was fast and painless.
You get 3 sets of UV blocking glasses that you can wear interchangeably (dark shades, clear lenses and what seem to be standard bifocal reading glasses, all made by or at least branded as RxLAL.

The way it will work is you get the procedure and follow up the next day.
Doc looks at your eye and how it is healing
Follow up the following week to see how everything is proceeding
If all is going well, you then follow up with him after the eye has completely or practically completely healed, at which point you will go through the standard refractive tests, "which looks better 1 or 2. Which looks better 3 or 4 and so on". It is at this meeting (and subsequent adjustment meetings) where you confer with your doc your near and far seeing desires.
Once these parameters have been decided on, they put you under some kind of UV exposure dudad and adjust the lens (which is very fast, I imagine a minute or so, I do not know since I have not had it done yet. They probably told me but I did not pay attention but it is fast). You them leave and continue to wear your UV blockers but now you are "test driving" these settings to see how you like them. I believe you do a total of about 2-4 adjustments over the course of 6 weeks total. All the while refining.
When you are both happy with the settings, you then come in to "lock" the lenses and that is it, you no longer need to wear the glasses. It is however, imperative to wear the glasses for every waking hour until the lenses are locked in since random UV can change and also lock in the lens in some unknown state (or perhaps lock in some parts of the lens. In any case, that lens would have to be removed and I imagine it will be coming out of your pocket to redo it (+ another 6 weeks). There is no limit to how long they will remain "adjustable" as long as you keep wearing the UV blocking glasses but they told me that in general, the whole thing takes about 6 weeks from start to finish.

One thing to keep in mind is what my doc told me, "the good thing about these lenses is that once you lock them in, you have them for life. The bad things about these lenses is that once you lock them in, you have them for life."

My results: I have only had it in since Tuesday and tonight is Friday. When I went in for my follow up on Wed, my eye was measured at 20/30. He told me that I was healing fast but had a little inflammation on one side of the eye. I don't think (though I did not ask to confirm) that they have an initial "power" since they can be adjusted and are meant to be adjusted post-op. I will ask when I go back for my right eye on Monday. The very first time I came out and saw my hands, they seemed to be surrounded by an orange, 3D halo surrounding all the fingers, that disappeared after the first day.

There are absolutely no artifacts and no halos, no glare. As with probably most other lenses, the world is exploding with color and computer text is BLACK again and no longer gray or light gray. My right eye which WAS the better eye now looks like I am walking around looking at the world through a sheet of dirty, yellow plastic at a constant dust storm. I can no longer remember how bad my left eye was and it was much, much worse than my right eye.

The only thing I cannot see clearly is detail that is probably about 14-15" away. I can see the very close things if I put on the bifocals. I will ask him what range of vision I can expect when I see him again on Monday and Tuesday (Tuesday, he will do the follow up on both eyes and the following week when I go in for the right eye, he'll take a look at the left too). I believe I then will go back in 3 weeks after that (I'm not exactly sure if they will start adjusting the left eye first or wait an extra week until they can adjust both at the same time since I'm doing both eyes).

My left sees and feels so much better that I can actually walk outside with only the clear UV blockers and not be blinded by the sun. My brain seems to completely ignore the right eye altogether.

Hope that helps any of you who need info to help you make decisions.

If you'd like to know about the drops, and how to apply them, it is not long but I need to sleep. I imagine it is probably very similar to what you have to do for other lenses except that you have to apply the drops in darkness. Let me know if you need any other details.

Is there any experience here with the light adjustable lens (LAL)?

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Thanks for your help!