Many people who have cataract surgery still need glasses after the sight-saving procedure. But a new kind of artificial lens could help more people be free of glasses after cataract surgery. It’s called the light-adjustable intraocular lens or RxLAL.
An intraocular lens (or IOL) is a tiny, artificial lens for the eye. It replaces the eye's natural lens that is removed during cataract surgery. The lens bends (refracts) light rays that enter the eye, helping you to see. Your lens should be clear. As we age, the lens can become cloudy, making things look blurry, hazy or less colorful.
While ophthalmologists make careful measurements of the eye and perform precise calculations, they cannot always achieve 20/20 vision without glasses after surgery. The reason is that the surgeon can only estimate where the IOL will fit in the eye after it heals from surgery. That’s important because determining exactly where in the eye the IOL will end up — the effective lens position — determines how close the surgeon can get the patient to 20/20 vision. Studies show that 30 to 50 percent of people who have cataract surgery still need glasses after surgery.
But, the new light-adjustable lens that just received Food and Drug Administration approval may solve this problem. This unique lens allows ophthalmologists to apply the patient’s prescription directly into the lens after the eye has healed from surgery by simply applying a low-intensity beam of ultraviolet light from a specialized light delivery device.
The lens is made of proprietary photoreactive silicone material. About two weeks after surgery, the patient sits in front of the light delivery device, their prescription is entered onto a display screen, and the device shines the specified profile of light onto the lens for one to two minutes. When the light hits the surface of the lens, the lens changes shape, thereby changing the power. The patient goes home, and when they wake up the next morning, their vision is improved.
The FDA study showed that approximately twice as many patients could see 20/20 or better after their final prescription was “written” onto the lens, compared to standard IOLs.
“It’s a game-changer,” said Vance Thompson, MD, an ophthalmologist who helped lead the clinical investigation into the new lens. “Patients like having a lens customized just for them. They get to choose the power they want.”
It’s like when you get a new prescription for glasses or contact lenses, and you’re shown different options, but you choose which lens gives you the clearest vision.
Dr. Thompson said this lens is for patients who want to fine tune their vision and don’t mind a bit of extra time and a little inconvenience to get it right. During the period after surgery and before the final light treatment , patients need to wear UV protective glasses at all times because the lens is sensitive to ultraviolet light until the light treatment process is complete.. The light adjustment procedure doesn’t hurt, but it does require additional follow-up visits at the doctor’s office, as the prescription is fine-tuned and ultimately locked in. Though this new lens doesn’t yet have a price tag, it is expected to cost more than the standard lens.
Dr. Thompson says he is excited to offer the new option to his patients. “It’s really powerful to be able to provide customized correction for each individual eye.”