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

Posted , 38 users are following.

The light adjustable lens (LAL) received approval by the FDA in 2017. I'm now offered this IOL as an alternative to a monofocal one. Is somebody here with experience - referring to treatment and outcome?

There is a thread in the forum introducing the LAL but it's three years old. They discussed the question whether the LAL is able to correct far, near and intermediate vision, achieving to be spectacle free at best. One member denied saying that you can only correct one distance like a monofocal lens. What is true?

Because I had rotation and unsucessful trifocal IOL treatment I very much appreciate the LAL with the possibility to correct the refraction several times after surgery when the lens is in place. Nighttime issues because of trifocal halos like concentric rings and spiderwebs around point light sources are not possible.

Sure there is the inconvenience to wear special sunglasses for several weeks from morning till dusk to protect the eyes from sunlight - even indoor and during showering but if it's worth the outcome I wouldn't mind.

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  • Edited

    i'm going to Codet on March 22 for the LAL. I'm 62 and high myopic ( -9 ). Right eye dominant, and have been in monovision ( contacts ) for the last 12 years. Left eye ( close ) cataract is alot worse then right. Hated monovision since day one, but needed the precise close vision for my work. I'm going there because of the EDOF enhancement that they offer. They do the exam on a Monday or Tuesday, first eye on Wednesday, follow-up on Thursday, second eye on Friday, follow-up Saturday. If everything is cool, you go home. Let me know if you have any questions and i'll ask them. My exam is on Tuesday and I'll get the answers then post them after i get done.

    • Posted

      I have researched the LAL being used as an EDOF and only have found a sentence here and there about it. From what I have read only the Codet Vision Institute in Mexico is trying the EDOF configuration, so you would be a brave early adaptor.

      Do you have links to articles providing details about the LAL being used as an EDOF and the statistically results. One feature that would be very nice is if the EDOF did not work for someone if they could adjust the lens back on a standard monofocal.

    • Posted

      I too was talked into monovision when I got lasik and HATED IT, so I went back in and asked to have them be the same but again let him talk me into "mini-mono" which I hated only slightly less.

      As for having to go to special clinic for EDOF, I'd be very skeptical. It is my belief (and experience thus far) that the lens is inherently EDOF. I have not had monofocals so I am not precisely certain how it works but if it is the same thing as in photography, it seems as though it refers to having a very limited depth of field. I did not ask for anything special with my IOL and have not gone through any adjustments yet but my left eye seems to see like it always has except for trying to read small print very close up (closer than about 14-15 inches (about 3-3.5" beyond my elbow). I can see clearly close, intermediate and very far.

      I cannot say whether this is typical or not but this is what I am experiencing. YMMV.

    • Posted

      The company is betting millions of $ that the edof is a very significant upgrade. It's going into trials in the U.S right now. Won't be available here for for 2 years. My left eye , like yours, is about useless. When I get there I will find out the details and decide then. I wanted the option to avoid any monovision so this is the only place to go.

    • Posted

      I wish you the best but as I stated earlier, my depth of field is from about 15" to infinity without even the first adjustment.

      The only thing I did notice today was that my left eye cannot "focus", everything is always IN focus, which is weird but you only notice it if you are looking for (and not finding) the bokeh effect you would see in a photo, while focusing on something in the foreground an expecting the background to blur out.

    • Posted

      From what they told me, they set both eyes to plano and then do the edof modification. My first question will be about reversibility of the edof. It depends on the availability of unpolymerized macromers in the lens. The less they have to polymerize it to get to plano, the more available. There's not alot of info, just that one table showing 90+% of eyes seeing 20/20 @ all distances. I figured if a small company is betting millions of $ on a trial, they must be very confident of the viability of the product. I will find out everything on march 23 and I will post answers.

    • Posted

      I would be very interested in knowing what you find out. I talked to a top clinical trial doctor about the LAL and he was super positive and thought it was one of the top innovation in cataract surgery. But that was using it as a monofocal. The fact is Doctors miss the refractive mark and this allows the IOL to be adjusted post op.

      The problem with the term EDOF can have a large spectrum these days. From what I have read the new definition is anything -.5D and greater. Lot easier to get -.5D EDOF than -2.0D EDOF.

      One question, do you live in Mexico or close. Or are you just getting the surgery there and having a US or wherever you are located Doctor do the adjustments as the whole process could take a while.

    • Posted

      Very encouraging. Can't wait to hear what it's like when you get the other eye done. I'm a big believer in the Latin word E pluribuskeepayoumitzoff so I would prefer not to do edof enhancement but I want the option.

    • Posted

      I'm in Phoenix and the round trip to San Diego is dirt+$10 ( aka $72 bucks ). Flights to and from major cities seems to be cheap these days. From the airport to the border is about $25 for uber or $7 for a bus / trolley. The hotel people will pick you up at the border and take you to the hotel. The Codet people will transport you to and from the clinic . If you just want to hang around the hotel or sneaker it, the only costs are hotel, food and TIPS. Since I'm there for surgery, I will be extremely careful about the food / fluid intake. This is no time to be doing the Guadalajaran Two-Step to the bathroom every half hour.

      The adjustments have to be done by them. They do them on Mon, Wed and Fri, so it will take at least a week.

      The cost of the surgery is about the same as in Phoenix ( $4,000 per eye ). The extra costs of the Codet trip comes down to Hotel + lost opportunity ( aka job ). The upside is you get to spend 2 weeks in warm, sunny Tijuana Mexico. A lot of people spend good money just to vacation there and travel to other cities on the Baja coast. You only live once and remember.... IT'S LATER THEN YOU THINK!

    • Posted

      Before I ask anything else, let me see if I understood what you wrote above.

      Are you saying that you are going to get the surgery done, to BOTH EYES, then get all the necessary adjustments, including the final to "lock" in BOTH EYES—ALL IN THE SPACE OF TWO WEEKS????

    • Posted

      Two weeks or so total in country. One week for install, then home for 2 or 3 weeks, then one week or so for adjustment.

    • Posted

      I realize this doesn't apply to you, as you have started down a different path. But, for you kids watching at home, I think of the adjustment week as a vacation. Btw, the adjustment only takes a minute or so but it is preceded by a full dilatation exam. This is necessary to get true numbers, but also because the full lens must be treated with the light ( the lens, the whole lens and nothing but the lens. So help me me ). So if you get your adj in the morning, your vision is going to be jacked for at least 2 hours or so. Then you can jump a tour bus and go to Rocky Point, Puerto Vallarta, Cabo or wherever. You don't have to back on base till the day after tomorrow, then its off again if you want. At the end of the adj period, you'll be tanned , rested, relaxed and have the best vision of your life. For a working slob like me, this is about as good as it gets.

    • Edited

      You know that in order to get adjusted your pupils need to be maximally dilated so it will take several hours just for your pupils to get back to normal and that there may be some amount of pink or red fringing, right? So depending on how long that lasts, you may not even be seeing "properly" or perhaps only half a day before your next adjustment.

      To me, that seems to mean that you might need to make decisions on how you want your vision to be be PERMANENTLY after just having tried it on for a few hours or a day, if at all.

      To me, that seems a bit "hurried" for a lifetime commitment. To me.

    • Posted

      Seemed kinda quick to me too, but I don't think they would mind if the adj time is stretched out. It's not like I'm staying at their house. I'll ask about it. As far as the edof goes, RxSight and Codet have been working on it a long time. Search reviewofophthalmology The Light-Adjustable Lens Goes Multifocal. This is from July 2007.

    • Posted

      Hello Robert! Thank you for your support!

      Like banterer and rwbill I'm curious myself about the EDOF-profile vs. monofocal LAL. As far as I know it's a profile applied on the surface of the IOL. Same question as you have: Is it reversible and you can try it out and if not satisfied go with some kind of monovision? I'm confused wether to opt for monofocal LAL or EDOF-LAL. Pros and cons? I have no experience with monovision.

      Your doctors at Codet Vision should be able to give you clarity on this next Tuesday. I'll be happy to hear what they say.

      The FAQ from Codet Vision about the LAL say that you will have good vision near and intermediate without using glasses. But SoCal Eye writes about the LAL that up close vision is not possible without readers. They suggest to choose trifocals if near and intermediate vision is of importance. It's confusing and I'm asking myself what you will be able to read with a light adjustable lens without glasses and which one serves best: EDOF or classic LAL.

      I wish you good days and experience at the nice and reputable Codet Vision Institut.

    • Posted

      I can only give my opinion and take it for the price paid.

      First as far as I know only the Codet Vision Institute is the only place offering the EDOF configuration.

      2nd I would not give much credence to a marketing brochure with the Wording, “GOOD”. That word means absolutely nothing statistically. Define Good. Is it 20/20 or 20/40 vision. One man’s Good is another man’s horrible. I have yet to see a single defocus curve for the EDOF LAL before or after all the adjustments.

      3rd I have yet to read any statistically meaningful article regarding the LAL used in the EDOF configuration. One article I read said they were doing MF but it was more like Progressive Glasses.

      Until the EDOF LAL is approved in other countries or even locations inside Mexico and you start to read Real-World results from Top Ophthalmologist I would be very cautious. In fact I have yet to even read clinical trial results.

      IMHO you would be a very early adopter and better be 100% sure on taking that risk.

      BTW, what country are you located in? I can give you the name of a Top US Clinical Trial doctor that thinks the LAL is the greatest thing ever (used as a monofocal) and you can contact him about this EDOF configuration and see if he knows anything about it.

    • Posted

      Thank you rwbill!

      First: Besides Codet Vision Institute the EDOF profile is already used in Europe as well.

      Yes, I'm interested in the name of the trial doctor. You can also send me a private message.

      Now we all wait for Robert's experience and the knowledge he will get from the doctors at Codet Vision. If you can try the EDOF-profile and then get back to try with monovision that would be great. If monovision is sufficient to serve my needs (I don't need very close reading below 10" for my work) then I could go with the monofocal LAL. But as I said before: I have never tried monovision. Refractive multifocality worked well with my former contacts. The diffractive trifocality of my actucal implants works - but monovision I don't know. Banterer and Robert don't like it as we can read here.

    • Posted

      Like everything else monovision works differently for each person. But in general the greater the vision difference is between the 2 eyes the greater the problem. Ron had links to articles that discussed this issue.

      It is a lot easier to use micro monovision to gain some more intermediate vision than use full monovision to obtain great close vision.

      From what I read the LAL is very popular instead of a Toric IOL.

      Because everyone results varies, especially with monovision, the ability of the LAL to be adjustable is a massive improvement for monovision. You can actual try different settings for each eye and then custom adjust. That is the amazing part!!!!

      This is from Rxsight and it was only a study of 25 people which is ridiculously small sample so factor that in.

      "In a single-center exploratory study to

      evaluate the use of the RxSight LAL at the

      Codet Eye Institute in Mexico, 25 bilateral

      patients with a target of -0.25 in the

      distance eye and -1.25 in the near eye were

      evaluated: 95 percent achieved 20/25

      UCDVA; 100 percent achieved 20/25 UCIVA;

      and 90 percent achieved 20/25 UCNVA, all

      with very low rates of dysphotopsias."

    • Posted

      If there is the ability to adjust the power of the lens circumferentially it may be possible to build in some astigmatism correction.

    • Posted

      I'm back from Codet. Surgery went smooth and I go back on April 9th and finish up on April 16th. Getting there from San Diego airport ( bus and tram ) was easy, but getting back across the border took 3 hours. I'll start a new thread about the whole thing when I get back.

    • Posted

      Thank you, Robert!

      Though I'll be waiting for your thread after April 16th. Glad that Codet did good work with smooth surgery. Question: Did you get the new LAL with the EDOF profile as you planned? The reason to go there. As I already know the profile is not reversible.

    • Posted

      Does that mean if one selects the EDOF option you can not try it out and reverse it? Also do you have any details on exactly how they are accomplishing this EDOF profile and how many diopters one gains.

    • Posted

      Sounds good: First waiting for the healing, second correcting possible refractive errors, third applying the EDOF profile according to your needs (maybe I'm wrong and the EDOF profile is a standard pattern).

      How near can you see at the moment without monovision? Distance should be pretty good.

    • Posted

      I don't think it can be reversed as there aren't enough unpolymerized macromers to do it.

      I didn't ask, but from what I read, the center 1.25 mm is smoothly raised to give a 1.25 D add. This 1.25 add seems to punch way above its weight. This might be old data but I will find out when I get back there.

    • Posted

      My situation is different ( worse ) then most anyone else. Hi myopic = long eye=low power lens. Lowest power available is 10. I need about an 8. That means the lens must be pulled down a long way with the adjustment. This means I am highly myopic for the next 2 weeks. ( Regular eyes will see 20/25 or so until the adjustment ) Lucky me.

    • Posted

      As power does not equal diopters, if you needed an 8 and are currently at 10, I wouldn't think you are highly myopic at this point, unless you have other factors such as a high astigmatism? For example, I had to pick between power 0, 1 or 2. The total difference in diopters between those was 1.1. I'd imagine it could be difficult though if you have to wear the special glasses until lockin, as you can't just order a pair of far-sighted (not readers) glasses off of Amazon or elsewhere to make up the difference.

      Thanks for posting about this iol. The LAL is offered in my city, but as with most options it's not offered in a power low enough for me to consider. It's certainly interesting to read about and seems like a good option to have less concerns about whether they can accurately hit the target in difficult eyes, it's too bad they don't (or can't, there may be limitations we don't know about) make it in lower powers. I hope you have a great result.

    • Posted

      Lasik on top is a an option if the cornea would allow it. It sure would be nice if an " off the shelf" solution would work for my problems, but it never has and I'll be dead and a half by the time they get around to coming up with them. Thanks, I could use some (good) luck for a change.

    • Posted

      For those who are still interested:

      The CEO and president of RxSight, Ron Kurz, presents valuable information and data during the AAO summit 2019. You can find it on YouTube (6:58) typing "RxSight - Innovation Showcase at Ophthalmology Innovation Summit 2019".

      There is a sheet that shows the study from CODET Vision cited by rwbil above this post and presenting the results of monovision - 1.0 D with the LAL.

      Very interesting is the defocus curve using the new EDOF profile. It's an amazing outcome if it really gets the shown results in practice. Again it's only an unpublished single center study with a very small amount of patients from CODET Vision Institute. Another study from CODET shows a comparison between PanOptix and LAL: The LAL with adjustable monovision exeeds the trifocal PanOptix refering to uncorrected binocular visual acuity - in all distances. I can hardly believe that.

      You may have a look yourself.

    • Posted

      Thanks for the info, I'll have a look.

      It seems as though the forum has temporarily disabled private messages.

    • Posted

      I very much hope they can fix the private message issue soon. Do you know what went wrong? They are just gone.

    • Posted

      I don't and now I can't even find any reference to messages at all.

      It doesn't seem very kosher to me.

    • Edited

      I found another window open with the message icon., clicked on it and still seeing this:

      Forums private messages disabled

      Private messages have been temporarily disabled. While we realise this will inconvenience a number of our users, we regrettably must remove this functionality while some critical issues are addressed. You will not be able to send or view any private messages on until further notice.

      Hopefully nothing nefarious is going on.

    • Posted

      i see same message. Hope they can fix private messages and reinstate them. was very useful feature.

    • Posted

      Robert, how are you? It's nearly two weeks after you returned from CODET and we haven't heard from you since then. I'm concerned. Best wishes!

    • Edited

      Sorry, got real busy.

      My high myopia causes big problems with my macula, so the vision result is not typical for this lens or the EDOF enhancement.

      The EDOF enhancement works well with no discernable downsides ( halos, etc ). Distance vision stayed the same ( with a very slight reduction in crispness ) and close focusing went from 5 ft to 2 ft. It made a huge difference, My compromised macula resolution is degrading vision alot. I think a healthy macula would make it perfect.

      I knew the macula problems going in, so I needed a near perfect optical solution to have livable vision and I got it. Nothing else would have come close to this for me.

    • Posted

      Glad that you are pleased with your outcome and everything went well.

      To unterstand the EDOF: Is it possible to use the adjustable monovision first to see how far/near one can get and maybe then put the EDOF on top to achieve spectacle independence? Or do you have to decide in advance whether to go with adjustable monovision or EDOF?

      I can hardly believe a chart from RxSight mentioned in my previous post to rwbil which compares trifocal PanOptix and the LAL with adjustable monovision showing that the LAL exeeds the PanOptix with regard to best visual acuity in all distances! How can this be achieved if you take in mind that a trifocal like my current implants uses 3.33 D for near add? Adjustable monovision uses -1.5 D up to 2.0 D at the most in the non-dominant eye. According to maths and optometry it's not possible. Can you help with this?

    • Posted

      Still no message function available. I guess your light adjustments are finished now. Can you have a look at your figures what they finally put in your right and left eye to achieve your great vision? I was told by an eye surgeon (who doesn't do the LAL but other IOLs) that I will never be able to read my smartphone or pocket books without glasses while using 1.5 D monovision with a monofocal lens. Nobody would be able to achieve this. My arm length is rather short (14") and I'm using the SE from Apple which is the smallest one. Permanently searching for reading glasses and putting them on and off is not what I want and it's not practicable during my work. Maybe I can put a higher amount of myopia in my non-dominant eye but if this works it would comprise my far vision he said. Far vision is needed for driving. I'm confused.

      How is your sight anyway?

    • Posted

      Take this for the free advice that I offer. I would be highly “suspicious”, Please feel in a better and kinder word as I am not a word smith, on the LAL EDOF.

      Results posted on a small study with probably cherry picked candidates, IMHO means next to nothing and even worst virtually no information on how the EDOF is even accomplished. As far as I know it could be like progressive glasses or the slightest EDOF gain by compromising SA.

      The statement that LAL EDOF can provide better overall VA than PanOptix at all distance with no halos is IMHO complete ……. I will let you fill it in the blanks.

      Heck I hope the LAL EDOF is the greatest thing ever, but as the old saying goes extraordinary claims require extraordinary proof and so far proof has been hard to come by, which speaks volumes to me.

      And on top of that I have contacted some top US Ophthalmologist in the US who were involved with the LAL and none of them know anything about the EDOF enhancements.

      Only time will tell but count me in the suspicious column!

    • Edited

      I was told by an eye surgeon (who doesn't do the LAL but other IOLs) that I will never be able to read my smartphone or pocket books without glasses while using 1.5 D monovision with a monofocal lens. Nobody would be able to achieve this.


      I have an AcrySoft monofocal in my right eye for 6 months now. I have been simulating a monovision of -1.25 in my left eye by using a contact lens that undercorrects by 1.25 D. With my right eye I can easily see the dash in my vehicles, and my distance vision is excellent at a bit better than 20/20. Reading normal size text starts to get difficult at about 18" or half a meter though.


      With my simulated monovision eye I can very easily read the J2 line on a reading test chart, and in brighter light and reading more slowly I can actually read the J1 line.


      I don't have any trouble reading my iPhone 8+ at 10-12 inches or so.


      I drive day and night in the city without glasses. However, if I was going to drive out of the city for longer distances I would use my progressive glasses though. We have issues in Canada with deer or moose coming out on the highway. Need good night vision to see them.

    • Edited

      Hi Assia,

      They had a computer problem my lock-in day but they were supposed to email me what they did the following week and I forgot to follow up with them about that. I will call them tomorrow.

      When I went in, after testing there were no adjustments to be made so we locked in. He said that my distance eye had achieved "plano" and measured 20/15. The close eye was 20/15 but he thought that if there were another line, I might have been able to see 20/10. I don't really know if the vision is truly that good but with the mono-vision, I don't need glasses at all and am ecstatic with my results. I can read almost any size print from about 12-13" away or so, any closer than that it does blur.

      It seems as though this site has quietly and permanently removed the private messaging.


    • Posted

      The results seem to be highly dependent on the macula. Everything I have seen confirms great results with the monovision solution. A good macula + the accuracy of the optics allows the brain to do better than expected.

      I can tell you with lousy macula's, the edof made a big improvement in near vision. I had 2 days between final adj and edof enhancement. Anything closer then 5 ft was blurry. Miserable. I would not have been able to function without glasses. Period. As it is, I have decent functional vision without glasses. I grabbed a pair of 1.5 bifocal safety glasses from home depot and they seem to work well for the small stuff.

    • Posted

      Yes we have lots of moose and deer here. Fatal accidents reported every year.

      even before I had cataracts I didn't like to drive at night outside the city.

    • Posted

      They indicate the private messaging is temporarily disabled - where did you see it is permanent? Not happy if they never bring it back. Was very useful.

    • Edited

      I do agree. At least they should make the written and received messages available. I didn't print or save them but I need the information which is included in the conversation. Dear moderator: Please pass this to the ones dealing with the message-function! There are people here in critical and stressful situations. I am one of them. The message-function is important and very, very useful. Please: Get it fixed and make it available again! Thank you!

    • Posted

      Hi Jorge!

      At least: They didn't skip us! You are my sunshine! I'm dreaming of 20/15, no glasses, getting back to normal life, just driving a car, working, living and seeing normal. Recently I had to undergo long distance night driving. It was a nightmare. I was completely exhausted afterwards, huge spiderwebs around every light. Many trucks on the road, construction sites.

      As I do now know: There will never be an improvement in my situation. I know this now for sure. I was told to wait for neuroadaption. But neuroadaption could never take place in my case because of the misalignement of both IOL. High astigmatism and significant toric misalignment spoil everything with trifocal lenses. They can't work as they should.

      Did you get your final measurements in the meantime? I wonder what the put in your lenses to achieve these great results. I suppose there are no gaps like you get with trifocals. Rather seamless vision. Is that true?

      Some practical thing: Did you drive back home after the UV-light treatments? Or after your 1rst follow-up the day after surgery? Was driving possible one week after the surgery when you came in for the second follow-up? The adjustments start later therefore vision is not accurate.

    • Posted

      Seems that the LAL really works well. Do you know how cylinder is corrected with the LAL? The UV light treatments can correct up to 3 D cyl. Does this mean there is no astigmatic correction put in the lens before it is implanted? If this is the case a person with high astigmatism won't see much until the first adjustment and has to wear glasses in front of the sunglasses to manage everyday life. In a brand new video on YouTube "Live Panel Discussion" from 4th May eye surgeons discuss the LAL saying that there are no rotational issues. Does this mean that there is no toric version of the LAL available?

    • Posted

      You are right: So far no miracles have to be seen in refractive surgery. One correction: The PanOptix chart refers to the LAL with adjustable monovision - not to the LAL with EDOF. EDOF is still examined by the FDA and results are expected in about one or two years.

      There is a brand new video from 4th May available on YouTube "The LAL Live Panel Discussion" which is worth watching. Unfortunately I don't understand what "negative asphericity" means. It is used to enhance near and intermediate vision with the LAL. The video shows: There are many patients very happy with the LAL and they are spectacle free. Sure they only pick the happy ones to present them in public but so far we haven't heard from unlucky patients. Do you know something about negative asphericity and how it works?

      The LAL is not an acrylic lens like most of the current models. It's a three piece silicone lens with PMMA haptics. Does anybody know something about material? Silicone is suggested to avoid positive dyshotopsia but there must be drawbacks otherwise acryl had not supersede silicone which is an "old" and well-known material.

    • Posted

      I thought most IOL had slight negative spherical aberration to counter the normal positive aberration of the cornea.

      Let’s start with the basics and think about this and I might be way off the mark.

      Spherical Aberration in simple terms is about the Spherical Lens focusing the incoming light on the retina at the perfect focal point. Now things get more complicated. For example your pupils get bigger when it is dim to let more light in. So light that hits one area of the lens, let’s say the center of the lens will focus light at a different spot than light that hits at the outer edge. This results in loss of focus and is referred to as Spherical Aberration.

      So the goal is for the lens to have the entering light to hit the retina at the exact right focal point.

      Astigmatism also plays a role but let’s ignore that.

      So if you introduce more Negative spherical Aberration you would increase your focal points and provide more depth of vision. But would that not come at the cost of focus quality and distance VA?

      They might also be doing a monovision like concept, where this EDOF is only done in one eye to gain a little bit of intermediate and close VA, while the other eye provides excellent distance vision.

      Interested to learn more about it.

    • Edited

      Hi Assia,

      I called them last week and they claimed that their system was still down! I was supposed to get it midweek last week but have received nothing. I will call them again as they should have everything resolved by now.

      There are no gaps in my vision. Unless, I close one eye, my vision is perfect from about 12-13 inches to infinity. I am not positive that I am indeed 20/15 but it is damn good.

      I'll try to get them to send it tomorrow but I don't have a way to send it to you privately now.

      Yes, I was able to drive the day of adjustments and the eve of lock in. The lock in, left my eyes with that pinkish cast which lasted about 2-3 days but it went away.


    • Posted

      No toric version. It's added by the light. My In my case , the left eye was both way short and 2.25 d astigmatic. It was a long 2 weeks.

    • Posted

      Oh no - my astigmatism in both eyes is worse. Glasses are needed for sure during the first 2 weeks after the surgery. That means prescription glasses put in front of the sunglasses and maybe additional readers. My nose is not that long.

      But: Arturo Chayet tested the new LAL without using sunglasses. 19 patients were involved. There were no unwanted changes of the surface. rwbill mentioned an article on Healio "UV-coated Light Adjustable Lens is the future" from 11th May which refers to the second generation of the lens and this test drive. You received the new and improved LAL already. Do you know about this trial without sunglasses? Or have you been strongly adviced to use them even though it wasn't necessary or not as essential as it was with the first generation of the LAL?

      Jorge reported about pinkish colour change after the final lock-in which lasted 2-3 days. Did you experience something like that? One reason why they improved the Light Delivery Device and the LAL using UV light absorbing material and an UV light blocker at the back of the lens was to reduce the amount of UV light hitting the retina. I hope you experienced the benefits.

    • Posted

      The rose glow was only noticeable that day and evening. The next day I didn't notice it much. They told me to wear the uv blocking glasses all the time.

      Have you found anyone to switch your lens for the LAL yet?

    • Posted

      This very unpleasant issue is haunting me day and night: Bilateral explantation 8 months after the surgery. The privat message-function is again needed to answer your question in detail. For now I have to leave it like that. But my short answer is: Yes, I did.

      If the surgery does not hurt structures (there are many dangers such as capsular rupture - maybe no LAL possible anymore. Then suturing a simple one to the iris .... - things like that) - so if it all goes well I'm still asking myself if the LAL is the best decision in my situation. I think it is but we are early adopters. No long term experience available. The fact that you experienced rose glow shows that despite improvements UV light still hits the retina. Does this cause hidden damages which will help AMD to progress or will it cause other diseases in the future? I'm rather young. Usually patients receiving the LAL are in their sixties or sometimes older. Did you talk with your doctors about this issue? CODET is absolutely no. 1. No one has more experience and knowledge regarding this lens.

      Another question that still bothers me: Do I need glasses afterwards, maybe swapping them all the time or is the information reliable that adjustable monovision achieves spectacle independence? The video "Live Panel Discussion" from 4th May shows happy patients, of course happy patients only. They are all 20/15 or at least 20/20 and spectacle free. I'm not a difficult case, my retina is okay, astigmatism up to 3 D is supposed to be correctable with high acuity by the LAL. But I was told to be prepared to wear glasses. They are on the safe side telling the patient that he/she will need glasses afterwards. But I wonder about the real results you get with the LAL if you are looking to a wider range of patients. Can't find reliable studies on that.

      But I found Jorge and you! Thank you that you are here!

    • Posted

      I understand the dilemma. The thing is, the LAL is the only lens that will give you guaranteed accurate refraction when all is said and done. Your eyes might not respond/heal in a predictable fashion when poked, jabbed and cut up for the second time ( might take it personal ). Do they just put in the same power lens they did before or is their some sort of fudge factor applied? If the bag breaks and they have to stitch it to the iris is there a fudge factor calculation for that? Sure hope it's centered correctly and it doesn't tilt when your eye heals. Whatever happens, your stuck with it. Think about that for a minute or two.

      All these possible ( permanent ) problems go away if you go with the LAL

      I was not impressed with the accuracy of final results doctors had with with regular normal untouched eyes, The final results with eyes that have had prior surgeries scared me.

      Do you have option for EDF with the LAL?

    • Posted

      EDF is not an option. They are waiting for the results from the FDA-study.

      I have toric trifocal implants at the moment. I think measurements/forumulas are different with the LAL.

      What do you mean by "all these possible (permanent) problems go away if you go with the LAL"? Do you mean if there is tilt or a not well-centered LAL the adjustments can correct after healing? I thought in my situation the LAL gives me the best options possible after explantation - no rotational issues, astigmatism can be fully corrected, trial mono-vision and absolutely no trifocal halos or other nighttime issues.

      You were not impressed with the accuracy of final results with regular untouched eyes. Is there a study or can you go more into detail? I'm very much interested in this. And of course in the final results from eyes with prior surgeries. Thank you, Robert!

    • Posted

      My ophthalmologist's top lead technician told me that the EDoF cannot be reversed.

      My question: Can EDOF be reversed?

      Their answer: No and there is absolutely no reason we would reverse from what we have seen. We have not seen any negative so why would we want to reverse it

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