Efficacy Of Light Adjustment Treatment On Refractive Accuracy Following Light Adjustable Lens Implantation: A Systematic Review And Meta-Analysis

Light Adjustable Lens (LAL) allows post-operative refractive customization through ultraviolet light treatments following cataract surgery. This study assess the impact of light adjustment treatment on refractive accuracy by comparing measurements obtained before and after light adjustment treatment in patient implanted with LALs.

Not applicable (systematic review of published studies).

Following PRISMA 2020 guidelines, PubMed, EMBASE, Cochrane Library, Scopus, and ClinicalTrials.gov were searched through 26 January 2026 for studies reporting refractive accuracy following LAL implantation. Studies reporting outcomes at both pre- and post-light treatment timepoints were included. Nine studies (271 eyes) met inclusion criteria; six were eligible for meta-analysis. The primary outcome was the mean difference (MD) in mean manifestation refraction spherical equivalent (MRSE) between pre- and post-lock-in measurement at short-term (<3 months) and long-term (12 months) follow-up; secondary outcomes included the proportion of eyes within ±0.25 D, ±0.50 D, and ±1.00 D of target refraction at pre- and post-adjustment timepoints.

Meta-analysis included five studies (117 eyes) for short-term and three studies (59 eyes) for long-term MRSE outcomes. Short-term pooled analysis demonstrated a statistically significant improvement in MRSE following light adjustment treatment compared to pre-adjustment measurements (MD −0.47 D; 95% CI: −0.64 to −0.30; P < 0.00001; I² = 39%). Long-term pooled analysis similarly demonstrated a statistically significant improvement in MRSE at 12 months post lock-in (MD −0.34 D; 95% CI: −0.61 to −0.08; P = 0.010; I² = 52%). Across studies reporting spherical equivalent accuracy, pre-adjustment rates of 35-68% improved to 86-97% within 0.50 D post-adjustment.

Light adjustment treatment significantly improves postoperative refractive accuracy following light adjustable lens (LAL) implantation, with a consistently high proportion of eyes achieving target refraction. These results support the LAL as an effective tool for refractive refinement after cataract surgery.