KOLOA, Hawaii — The evolution of IOL choices has been “very exciting,” Neda Shamie, MD, from Maloney-Shamie Vision Institute, said at Hawaiian Eye 2020.
“We’ve come a long way from the 1950s when the first lens was implanted, and in the last decade, this has really been rapid fire to the point where we can’t keep up with the new advances,” she said.
However, with more choices comes new challenges, according to Shamie. These challenges include increased chair time, reliance on optimized preoperative measurements, outcome limitations and difficulty predicting patient tolerance of glare and halos and loss of contrast, she said.
“The Light Adjustable Lens (RxSight) is ... an innovation that is unlike anything else that has been presented to us,” she added.
The Light Adjustable Lens can be modified or enhanced after implantation to reduce reliance on preoperative issues. In fact, the lens shifts the discussion from preop to postop, which is more predictable and removes the unknowns, she said.
“You are throwing your dart at a target that is visible and clear and not moving, and this is where I think the value of this is,” Shamie said. “You are no longer trying to explain mini-monovision or ascertain tolerance to glare and halos with multifocals. And the chance of unhappy patients is minimized.”
According to Shamie, the Light Adjustable Lens is ideal in patients with refractive lens exchange and astigmatism up to 3 D to 4 D, and in those who are wary of glare and halos.
But the lens should be avoided in patients with pupil dilation less than 6.5 mm, who take medications that cause photosensitivity, who are unable to return for postop treatments and light adjustments, who are not willing to wear UV protective glasses and who expect a full range of vision without glasses, she said.
“The Light Adjustable Lens is truly a disruptive technology in this field that allows office-based optimization after cataract surgery and can hopefully lessen the number of unhappy patients,” Shamie said. – by Alaina Tedesco
Reference: Shamie N. Incorporating the LAL: Practical pearls. Presented at: Hawaiian Eye 2020; Jan. 18-24, 2020; Koloa, Hawaii.
Disclosure: Shamie reports financial disclosures with Allergan, Alcon, AMO, Avedro, Bausch + Lomb, CorneaGen, CRST, Glaukos, Ocular Therapeutics, Omeros, Oyster Point, Sun, TearLab, Visionary Ventures and Zeiss.