Cataract surgery involves the removal of the cloudy natural lens of the eye, which is then replaced with an artificial lens known as an intraocular lens. Traditional intraocular lenses have fixed focusing powers, which are calculated before surgery. However, slight discrepancies in lens placement or wound healing can lead to refractive errors (vision problems that make it hard to see clearly), necessitating the use of glasses or contact lenses for sharp vision. Light adjustable intraocular lenses could help people be free of the need for glasses after cataract surgery.

What are light adjustable lenses for cataract surgery?

Light adjustable lenses are an innovative type of intraocular lens used in cataract surgery that allows for postoperative adjustments to the lens power, providing patients with the ability to fine-tune their vision after surgery. These lenses are designed to adapt to the specific visual needs of each patient, which can significantly enhance the accuracy and quality of their vision.

Light adjustable lenses represent a significant advancement in the field of cataract surgery, offering patients the opportunity to customize their vision after cataract surgery. Developed to enhance visual outcomes after cataract removal, these lenses allow both the patient and the surgeon to adjust the lens power after the surgery has taken place, which can lead to a more precise visual correction.

How do light adjustable lenses work?

Light adjustable lenses are made from a special photosensitive material that can change shape and power when exposed to ultraviolet (UV) light of a specific wavelength. About two weeks after surgery, once the eye has healed, any post-operative refractive error that is identified can be adjusted by correcting the refractive power of the lens. The adjustment process typically involves three to four sessions of light treatment, allowing for incremental changes until the desired visual outcome is achieved.

What is the adjustment process?

During each session, you and your Coastal Skin and Eye Institute ophthalmologist can demonstrate changes to show you how your vision will improve based on your personal preferences before the changes are made. The adjustments are painless.

The UV light is applied to the lens through a device similar to a slit lamp (which is commonly used during eye examinations). The light causes the photosensitive silicone within the lens to change in a controlled fashion, adjusting the curvature of the lens, and thus changing its optical power. The adjustment process can correct nearsightedness, farsightedness, astigmatism, and other higher-order vision abnormalities. These adjustable lenses are also valuable for patients with prior refractive surgery.

What are the advantages of light adjustable lenses?

The primary benefit is the ability to customize the lens power after surgery, helping patients achieve better visual outcomes tailored to their individual needs. These lenses provide a high degree of vision precision in correcting vision, which is especially advantageous for patients with complex refractive errors. Fine-tuning the lens power can potentially reduce the need for a patient to depend on glasses or contacts to improve their vision.

What are the considerations and limitations of light adjustable lenses?

While the technology offers considerable benefits, there are some factors to consider:

• Patients must wear special UV-blocking glasses from the time of the initial surgery until the final lens adjustment is locked in to protect the new lens from uncontrolled exposure to UV light.
• There is a limit to how many times the lens can be adjusted after which the final prescription is locked in using a final UV light treatment.
• Light adjustable lenses are more expensive than traditional IOLs. Medicare and PPOs will cover the cost of cataract surgery using a standard single focus lens. An additional charge for this special lens must be paid out of pocket.

Are light adjustable lens cost effective?

Studies report that cataract surgeries performed with light adjustable lenses are cost-effective when compared to those performed with monofocal intraocular lenses.

The light-adjustable lens is the first Food and Drug Administration (FDA)-approved product from an entirely new category of intraocular lenses (IOLs). The FDA study reported that about twice as many patients had 20/20 vision or better after the final adjustment of the lens. Light adjustable lenses are a game-changer. They are safe and offer the ability to maximize vision after cataract surgery.

Contact Coastal Skin and Eye Institute to schedule a consultation with one of our ophthalmologists to find out if you are a candidate for light adjustable lenses during cataract surgery. We have offices in Carmel Valley, Encinitas and Grossmont for your convenience.

---

References

• https://www.aao.org/eye-health/news/new-iol-adjustable-after-cataract-surgery
• Nishihara TW, Hu JQ, Buchholz RD, Murphy JD, Afshari NA. Cost-Effectiveness Analysis of Light
• Adjustable Lens Compared to Monofocal Intraocular Lens in Cataract Surgery. J Refract Surg. 2023 Nov;39(11):777-782. doi: 10.3928/1081597X-20231016-01. Epub 2023 Nov 1. PMID: 37937762.
• Jun JH, Lieu A, Afshari NA. Light adjustable intraocular lenses in cataract surgery: considerations. Curr Opin Ophthalmol. 2024 Jan 1;35(1):44-49. doi: 10.1097/ICU.0000000000001015. Epub 2023 Nov 2. PMID: 37916944.
• Chayet A, Sandstedt C, Chang S, Rhee P, Tsuchiyama B, Grubbs R, Schwartz D. Correction of myopia after cataract surgery with a light-adjustable lens. Ophthalmology. 2009 Aug;116(8):1432-5. doi: 10.1016/j.ophtha.2009.02.012. Epub 2009 Jun 4. PMID: 19500852.