Eyeworld

SUMMER 2025 | EYEWORLD | 39 R Dr. Loden agreed that you want to be care- ful with the approach to monovision in this lens. You can't adjust for near vision and if they don't like it, adjust 1.75 D back for distance vision without inducing the risk of aberrations. You have to pick a goal, stick with it, and do as few adjustments as you can. "We're trying to push our adjustments off a little more. One of the things we used to do was if we missed the IOL power calculation, we would do a quick adjust- ment at 10–14 days out, an off-label adjustment early, to get them where they could see and be functioning," he said. But he's trying not to do that now unless it's completely necessary. "We're trying to wait longer for the adjustments. We never do a third adjustment. We would rather come back and do a laser procedure or a piggy- back lens than a third adjustment," he said. "But I think that no matter what you do, you're going to have a rare lens that's not going to perform exactly as you think it is, and you may have to intervene." Dr. Thompson, who has been part of the FDA studies for the LAL from the beginning, sees more and more uses for both the LAL and LAL+. "Because these are the only lenses that can be adjusted after refractive error has oc- curred, they are the most accurate, demonstrat- ing both better uncorrected and best corrected vision than monofocal control lenses in two FDA trials," he said. "We can combine this accuracy with the broadened depth of focus to provide our patients with an excellent visual solution. Most patients, even those who have not tried blended vision before surgery, will find it a great way to achieve both high quality and range of vision, generally with small differences between the two eyes," he said. He also noted some factors to pay attention to, particularly for physicians who are new to adopting this lens. He generally recommends getting familiar with insertion and light treat- ments with the LAL before moving on to the LAL+. Dr. Thompson said the technology is much more forgiving than excimer surgery, since it allows multiple non-invasive treatments, but doctors still need to treat it like refractive sur- gery. This includes making sure the refraction is stable and accurate and that the LDD targets for each eye are appropriate. "You want a crisp refractive endpoint," he said. "If it's not 20/20 crisp, we may not have continued on page 40 The Light Delivery Device at OVO LASIK + LENS Source: Mark Lobanoff, MD

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