EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1529000
WINTER 2024 | EYEWORLD | 37 C Relevant disclosures Khandelwal: None Lee: None Shamie: RxSight Strange: RxSight of patients considering this lens in his practice. He noted that the additional range is not the same for every patient, though this is the case with any IOL. "Just as important is the fact that the LAL and the LAL+ are available down to +4.0 D, which allows offering the IOL to very high myopes who appreciate that their IOL calcula- tions are more challenging but are used to the accuracy of a contact lens," Dr. Lee said. 'Everyone had to be educated' Dr. Shamie said her senior partner, Robert Malo- ney, MD, was involved in the LAL development, and her practice was involved in its clinical trials. Since then, they've considered it to be a paradigm shift in the way they perform cataract surgery. "The Light Adjustable Lens offers the opportunity to fine tune vision … after the lens has settled in its position, after the cornea has healed, and after the refractive outcome has stabilized. We then take that refractive out- come, plug it and the refractive target into the By that point, we know how long those patients take to dilate, and they do not need refraction and the same type of counseling." When it comes to patient selection, Dr. Lee said he'll discuss the LAL with all patients who are candidates, even if they are not classic post-refractive or monovision patients. Many patients, he said, have specific refractive goals and are attracted to the increased accuracy offered by the LAL. Some have also decided to try monovision with the LAL and found out that they really enjoy it. "I do mention to those patients that if they don't like monovision, they will not have full range of vision to try to make sure they aren't surprised or disappointed," Dr. Lee noted. For the surgeon who is already experienced with the LAL, Dr. Lee said a more advanced use of the lens is in cases where the capsule is not intact, such as post-YAG IOL exchange cases. "I also mention it as a back-up option for patients who prefer a different IOL as plan A but have a higher risk for intraoperative issues, such as a posterior polar cataract," he said. When it comes to the latest iteration, the LAL+, Dr. Lee said it has increased the number continued on page 38 Kristin Barnes, OD, of Maloney-Shamie Vision Institute, performs a non-invasive light adjustment on a patient 3 weeks following his Light Adjustable Lens procedure. Source: Maloney-Shamie Vision Institute