A woman gets her eye tested and measured by an ophthalmologist for light adjustable lens implantation.

Think of traditional laser surgery and glasses like Polaroid cameras. They can give you great results—sharp vision—but once the image (or in this case, the vision correction) is produced, it’s permanent. If you’re not happy with it, your options for change are limited.

That’s where Light Adjustable Lens (LAL) changes the game. LAL, a newer advancement in ocular implants for the treatment of cataracts, works more like a smartphone camera. Surgeons can adjust a LAL after implantation, similar to how you can toggle the camera settings and edit photos on smartphones. This innovative lens technology allows for customization of your prescription to complement your lifestyle through testing your vision in real-life before locking it in. 

Defining Light Adjustable Lens (LAL) 

The Light Adjustable Lens (LAL) is an intraocular lens (IOL) implant containing UV-sensitive molecules called macromers. The macromers respond to UV light, which surgeons use to activate the lens’ effects (more on this below). These are referred to as light treatments, and surgeons can administer up to three adjustments using the Light Delivery Device (LDD) to precisely fine-tune the Light Adjustable Lens until the optimal vision correction is achieved. These properties give LAL distinct advantages over other IOLs:

  • Unlike other IOLs, LAL can be adjusted after surgery.
  • The flexibility of adjustments allows for the LAL to be fine-tuned after implantation which means optimal visual results. 

How LAL Works 

Surgeons implant the LAL using standard cataract surgery techniques. Once implanted, the eye is given 4 weeks to heal and achieve maximum refractive stability. Afterwards, usually 4-8 weeks after surgery, the patient returns for vision testing. 

The surgeon will work with the patient to preview and compare possible vision outcomes based on their lifestyle choices and habits. Going back to our camera analogy, this is where you can select your lens’ “settings” or in other words, tailor a prescription that allows you to carry out your activities to the fullest. 

For example, if you spend a lot of time reading or using a computer, your surgeon may recommend “settings” that improve your near vision. But if you’re into sports like tennis or golf, they might prioritize distance vision instead.

After your target prescription is selected (remember, this could take up to three adjustments), the surgeon will shine a light delivery device (LDD) on the lens to give its final form. 

The LDD is a 5-step process, but it only takes 90 seconds. 

  1. The surgeon directs UV light into the lens, targeting specific macromers.
  2. When exposed to UV light, these macromers begin to harden and bond together—a process called polymerization, which means they are solidifying.
  3. Unpolymerized macromers (not yet exposed to UV light) move into the exposed areas, causing the LAL to change into its desired shape. 
  4. The entire lens is now exposed to the light, and polymerization of the remaining macromers occurs. This is the lock-in phase. 
  5. The newly locked-in LAL exhibits and holds a precise power change and shape customized to the patient’s prescription. 

Once locked in, the changes are permanent. 

Is Light Adjustable Lens Right for You?

Light adjustable lenses can treat a wide range of patients. But like all forms of laser eye surgery, LAL works better for some patients compared to others. It’s vital to know your eligibility so that your expectations of LAL are (excuse the pun) well-adjusted. 

Ideal LAL Candidates

  • Have cataracts or other lens-related vision problems that require surgery.
  • Have healthy eyes and do not have significant underlying eye diseases or damage.
  • Are over the age of 18 and have stable vision.
  • Have had previous eye surgery that would affect the outcome of LAL surgery.

Poor Candidates for LAL Surgery

  • Patients taking medications that increase sensitivity to UV light.
  • Patients taking medication that may cause retinal damage as a side effect.
  • Individuals who have a history of herpes eye infection. 
  • Individuals who have uncontrollable eye movements (nystagmus). 
  • Individuals who can’t comply with doctors’ post-operative care instructions (such as wearing UV-blocking glasses). 
  • Patients whose pupils dilate less than 6 mm
  • Patients with more than 2.5 diopters of corneal astigmatism

When determining if you’re a good candidate for LAL, a thorough vision exam is necessary to rule out any hidden factors that may exclude you from treatment. 

An Origin Story: The History of Light Adjustable Lens

Naturally, you might have questions about the success rate of this newer form of laser surgery. The good news is that LAL has a strong track record despite it being relatively new. One clinical study of 600 patients found those who received LAL were twice as likely to achieve 20/20 vision at six months without a need for glasses compared to those who received traditional implants. So those traffic signs you might struggle to see—you’ll finally see them from afar without having to squint! 

A major reason for LAL’s high efficacy comes from the reason it was invented—to address unsatisfactory outcomes that were common for cataract surgery. 

For example, poor wound healing and lens position, along with inaccurate eye measurements (biometry) sometimes led to negative outcomes. 

In 1996, Danial Schwartz, M.D. from the University of California, San Francisco, and Robert Grubbs, Chemistry Professor at the California Institute of Technology launched the LAL project.

Together, they developed the lens, which showed early promise, but it wasn’t until 2017 that LAL received FDA approval. Since then, it’s become a more widely available option for patients looking to correct cataracts, astigmatism, and other visual issues. 

Lumea is a Leader in LAL Implantation 

Of course, surgical experience and expertise matter. If you’re considering LAL to correct your vision issues, you need to consult surgeons who specialize in LAL implantation, and finding surgeons with experience is not yet commonplace. 

Fortunately, you can find qualified LAL surgeons here at Lumea. 

Not only were we the first clinic in Canada to introduce LAL technology, but we’re also the most successful at it. We reached a milestone of over 500 LAL implantations, making us the leader in this surgery. Lumea surgeons have perfected the art of correcting eyesight with LAL with minimal side effects and maximum vision correction. We’ll restore your vision to what it once was—or perhaps to a clarity you’ve never had the pleasure of experiencing. 

Take the next step to clearer vision today. Contact us today to schedule your consultation and discover how LAL can transform your life.