Integrating The Light Adjustable Lens In A High-Volume Practice: Optimizing Workflow, Adjustment Strategies, And Clinical Outcomes

To describe how a high-volume, private-practice, integrated the Light Adjustable Lens (LAL) into our practice, optimized workflow, refined adjustment techniques and present clinical outcomes.

High-volume, private-practice in Canada, with an ethnically diverse patient population.

Preop assessments included optical biometry, corneal topography, and macular optical coherence tomography. Standard phacoemulsification with in-the-bag LAL implantation was performed, followed 3 weeks later by refraction and counselling of patients regarding their visual goals to determine the target refraction for each eye. Up to 3 postoperative refractive adjustments were performed using the RxSight Light Delivery Device (LDD). Lock-in treatments with the LDD were performed to prevent further refractive change once visual goals were achieved.

Results (N = 1,000 eyes) showed that 92% of patients were targeted for blended vision (distance target in the dominant eye and near target in the non-dominant eye); 96% achieved UDVA ≥20/20, 34% achieved ≥20/15, and 85% achieved ≥20/20 with J1 near vision. The mean near refractive target was -1.30 D. Overall, outcomes and tolerability were favorable. 30 patients reported visual phenomena almost exclusively in near eyes: 28 mild, 2 moderate, none were severe.

The LAL introduces a novel concept in cataract surgery for presbyopia mitigation through blended vision and refractive customization. Our clinical experience suggests careful patient selection, standardized adjustment protocols, and robust workflow planning are critical for successful integration.