LAL - Final Adjustments

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I got the second adjustment this week on my new RxSight Light Adjustable Lens. Here's a report for anyone who may find it useful, or anyone who cares to offer advice or opinions.

  1. Before the second adjustment, refraction was -1.75 D sphere, -1.00 D cylinder.
  2. Vision was tested by the optometrist at 20/70 and J1+ for far and near respectively.
  3. Target refraction for the first adjustment 10 days prior was -1.50 D/0.00 D. So, the adjustment was pretty accurate on sphere, but way off - actually nothing - on cylinder. The optometrist was suprised by this and speculated that because of the large amount of myopia added in the first adjustment, the machine was unable to do any cylinder adjustment last time. (In the first adjustment, she had targed a myopia increase of 2.00 D and the actual myopia increase was measured at 2.25 D, from the pre-adjustment result of +0.50 D hyperopia).

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  • Edited

    I have worked out my plan for LAL adjustment #3 - I intend to ask the doctor to correct my remaining astigmatism this week, and then lock in. This will leave me at -1.75 D sphere, 0.00 D cylinder.

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    I estimate my remaining astigmatism at -0.375 D. I expect the optometrist will call it -0.25 D and I hope they are willing/able to make the small cylinder adjustment. If not, I'll be satisfied with locking in what I have right now.

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    -1.75 D sphere is less nearsightedness than I originally planned, but I now think it's the best target for this lens and for my monovision reading eye. I'm trying out my target final vision with the LAL eye using a -0.50 D cylinder lens, and I find I am still able to read tiny print (better than J1+) and read a book comfortably at 15-20 inches distance using my LAL eye alone. -1.75/0.00 gives me excellent near vision, good intermediate vision, and semi-adequate distance vision. I suspect I am getting a good result for depth of field because of two factors: 1. the lens optics and 2. my small pupil. Based on what I am seeing, -2.00 D would be overkill.

    • Posted

      Keep in mind that reducing cylinder will reduce near vision. And not sure if you want to go down the Lasik road again, but it is much better at reducing myopia, and poor at increasing myopia. The corner that I have painted myself into is high cylinder (-0.75 D), and low sphere myopia (-1.25 D). Together they make for good -1.625 D SE (but not ideal) near vision. However if I was to reduce cylinder only, I would lose a significant amount of near vision, combined with not being able to increase sphere.

    • Edited

      I understand on the cylinder correction reducing my near vision. The home lens kit helps - I spent much of the day with my natural eye covered and my LAL eye fully corrected for astigmatism, and found the near vision is still fully satisfactory. Without my astigmatism I do need to hold the phone or book or whatever an inch or so farther away from my eye, but I'm still able to comfortably read very small print.

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      I take your point on LASIK to increase myopia. I have no intention of having any more operations on my old eyes, unless absolutely necessary. I do not want to press my luck! This was one of the reasons I went with the LAL - to avoid the need for further refractive surgery. Thanks for the advice, RonAKA.

  • Edited

    Exam/treatment today following last week's second light adjustment (monovision reading eye):

    • Uncorrected vision:
      • Near: J1+
      • Far: 20/40 +1
    • Refraction: -2.00 D sphere, 0.00 D cylinder
    • Corrected vision:
      • Far: 20/15

    I was fully satisfied with my vision results, so I got the first of two lock-in treatments today.

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