Eyeworld

I DECEMBER 2019 | EYEWORLD | 45 Contact information Doane: jdoane@discovervision.com Slade: sgs@visiontexas.com Waltz: kwaltz56@gmail.com Wiley: wiley@cle2020.com Another limitation is if a patient takes photosensitizing medications; this could include patients on various types of diuretics, Dr. Slade said. However, patients can still use the lens if they can discontinue photosensitizing medica- tions during the light adjustment process, Dr. Doane said. LAL pearls With all the excitement over the LAL, it could be easy to dive in without much thought. How- ever, surgeons share a few pearls to help poten- tial users better plan for their LAL experience. 1. Do a site visit. Just as you would with many other types of new surgical technology, plan a site visit with someone already using the lens, Dr. Waltz advised. The cataract surgery itself is the same, but surgeons and staff will want to see the light adjustments and patient education as well as review scheduling nuances. 2. Consider scheduling. A key consideration with the LAL is the light adjustments that are done, Dr. Waltz said. For each cataract patient you treat who will get an LAL, there's the po- tential for up to three separate light adjustments One advantage that both patients and surgeons like is being able to try out monovi- sion before it is locked in—in fact, patients who like monovision often are a good match for the LAL, Dr. Slade said. This is in contrast to patients in the past who received monovision with their IOLs and were unhappy with their vision. Surgeons were always left to wonder if the patient was unhappy with their actual vision or with monovision itself. Another good group of patients for the LAL are those with previous refractive sur- gery—in fact, there is a trial now for this patient group, according to RxSight. "Someone with previous LASIK has already said with their pocketbook that they find their vision import- ant," Dr. Waltz said. Poor candidates for the LAL There are a few medical reasons why someone may not be a candidate for the LAL. For instance, a patient who has a small pu- pil that does not dilate well is not a good LAL candidate. "The pupil has to be larger than 6 mm to achieve the light adjustments," Dr. Wiley said. If a patient has astigmatism that is greater than 3 D, the lens may not be ideal, Dr. Wiley added. continued on page 46 The Light Adjustable Lens Source (all): Stephen Slade, MD About the doctors John Doane, MD Discover Vision Center Kansas City, Missouri Stephen Slade, MD Slade & Baker Vision Center Houston Kevin Waltz, OD, MD Partner, Whitson Vision Indianapolis William Wiley, MD Cleveland Eye Clinic Cleveland Relevant financial interests Doane: RxSight Slade: RxSight Waltz: RxSight Wiley: RxSight

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