Light Adjustable Lens (LAL) First Light Adjustment - What To Expect - Vision Correction w Light

[@SharonSews]

The starburst happened to me after my first adjustment also. It’s been a journey of six months so far. The starburst have not gone away, nor have they been able to determine the cause. When I chose to do these lenses, I could not find any negative feedback online. Thank you for sharing your experience, and I do hope they have a solution for you.

[@LKearns]

I am sorry to hear of your situation. The struggle is real. Thank you for reaching out. I will keep you advised as my doctors and I explore different options. Can you tell me what you all tried?

[@mmerwin2294]

Watching your videos. Very helpful. Am having the LAL put in next week. Hope you will follow up with info on your second light adjustment. Was the starburst problem resolved?

[@mikinovakstrom9687]

I’m hungry for a follow up this video!

[@LKearns]

You are too kind. Been trying to work out some vision issues before posting again, but hope to be able to do so within the month. Second adjustment not yet scheduled until things stabilize.

[@djlane5213]

Yikes! I’m right behind you. My first adjustment is 36 hours from now, and we’re supposed to correct astigmatism first. The procedure you went through doesn’t look exactly like I had envisioned, so I’m glad I got to see it and hear your questions and your doctor’s responses. Subscribing now!

[@LKearns]

You got this! The adjustment is really pain-free and interesting.

[@shafiqhossain6333]

How was your first adjustment regarding the astigmatism correction? My first adjust in about 4 days is for the very same reason.

[@shafiqhossain6333]

Thank you for your feedback. Very helpful indeed. My first surgery (right eye) is scheduled for this Tuesday. Wearing contacts on my left eye. Honestly, I am more anxious about the adjustment phase rather than the actual surgery. Worried about whether my last adjustment may be worse than prior adjustments. Wondering if the adjustments should be based relative to my left eye or totally independent. Have you had your second adjustment and if not, how is your vision thus far?

[@LKearns]

No second adjustment yet. Still working out some issues related to double vision. But my astigmatism in that eye is virtually gone and distance is excellent. I only had cataracts in one eye but suspect getting them both done around the same time is the best way to go so you can adjust them for perfect balance. The best of luck to you!

[@shafiqhossain6333]

@@LKearns I'm in same boat regarding my other (left) eye. As far as I can tell, cataract has not progressed far enough to impede any noticeable clarity of vision. But now I'm wondering I should just go ahead and get it done right now to balance out the vision. I'm was thinking of asking the doctor to adjust the right eye for intermediate to distant vision and use my left eye for near vision. Currently wearing contacts on my left eye so am prepared to adjust the prescription if needed to focus more on near. Let's see..... Hoping all the best for you. Will update you after I come out of surgery tomorrow. By the way, how did you feel rest of the day on the day of your surgery? Should I expect to be drained out or rest in either case instead of reporting back work (remote)?

[@LKearns]

I too am trying for distance vision in the right and will get the left more toward near. That is what I have had for the last 30 years after LASIK. For some reason my brain is struggling more this time. As far as after surgery, I felt great, although not quite certain I would have returned to work. Having said that, I did shoot the close out to my Surgery Day video two hours after the procedure. If you watch that video you can judge for yourself. kzbin.info/www/bejne/n6fYkoqPmM-lo8Usi=8LTm4t4J4iKSNyNF

[@shafiqhossain6333]

@@LKearns Had your second adjustment yet? How did it go?

[@LKearns]

@@shafiqhossain6333 still no second adjustment. Battling binocular double vision and until we have that better understood I'm not changing anything. How about you? How is your LAL journey progressing?

[@arelbaskan5133]

One of the most informative videos for LAL, thanks for the detailed, clear guidance. I had LAL six months ago on my non-dominant eye and had two adjustments. Still not locked in. With -0.5, my computer distance got way better but not good enough for the phone (around J4). My distance was 20/15 after the first adjustment to plano, but now it is 20/25 with -0.5, and the distance is not as sharp as it was after the first adjustment. You tried to avoid EDOF during the first adjustment, but you might still have triggered it as you moved toward the myopic direction around -1.75 (from +1.50 to -0.25). My understanding is that any myopic movement greater than 0.5 adds EDOF during the first treatment at the expense of sharpness.

[@LKearns]

Thank you for the kind words. Interesting thought about the EDOF, so I checked it out. Apparently the criteria to trigger EDOF are threefold: 1. Move by at least 0.50 diopters toward myopia 2. Be the first adjustment 3. Target at least -0.50 or greater myopia… Since we targeted -0.25 we did not trigger the additional EDOF. However, any steepening does inherently increase DOF but not additional DOF. Hope that helps.

[@alven5769]

I was thinking the same. Could the EDOF been triggered under the 1st point- moving more than -0.5 D?

[@LKearns]

@@alven5769 according to what I've been told, the criteria to trigger EDOF are threefold - and all three criteria have to be met simultaneously: 1. Move by at least 0.50 diopters toward myopia 2. Be the first adjustment 3. Target at least -0.50 or greater myopia… Since we targeted -0.25, my optometrist/light adjuster who has done more than 1000 of these adjustments, says we did not trigger the additional EDOF. However, any steepening does inherently increase DOF but not additional DOF.

[@shafiqhossain6333]

@@LKearns Were you able to confirm whether this was specific to LAL or will it work on LAL+? Additionally, what if I do this for the first adjustment and my distance vision becomes worse. Can I backtrack during the second adjustment to restore the clarity I had prior to the first adjustment?

[@angelitopineda3278]

Hi sir , thanks to your video. I woul like to ask sir. I am already operated months ago, with intra ocular lens but im not satisfied sir. Can i proceed for the light adjusment lens sir. Need some advice 🙏

[@DebRiddle-do4th]

Had my first adjustment about two weeks ago, next appointment is next week. I did see starbursts, but within two days it was gone! I love these lenses!!!

[@LKearns]

Fantastic! Unfortunately it looks like my starbursts are coming from HOAs/irregularities on my cornea that the lens can't correct. However, if I take Lumify drops prior to night driving, it's definitely tolerable. Good luck on your next adjustment!

[@DebRiddle-do4th]

@@LKearns Oh I see. Thank you. It's quite a journey, isn't it? complete with light shows HAHA

[@lindacutrara9172]

@@LKearns And what type of irregularities. They weren't aware of those irregularities before the implantation?

[@EatLeadPal]

Thank you for this video. I'm 63 years old, have used readers since I was 40 and am now getting to the point where I need full time glasses. I went to a recommended ophthalmologist to get Lasik. He told me that Lasik is not permanent and at my age, that my eyes will continue to get worse and I will need glasses again. He said lens replacement is permanent and I would never need glasses again and would never get cataracts. He then offered me a 3 choices for lens replacement. Monovision with one lens for distance and one for up close; Multifocal for both eyes; or LAL. I'm real bad at making decisions like this when there is no clear answer.

[@LKearns]

That is completely understandable. All lens types have their pluses and minuses. I had LASIK over 25 years ago and it was quite stable, but we all pretty much develop cataracts later in life and will need them removed and new lenses inserted. I urge to have some good deep discussions with your ophthalmologist (one who is very experienced in all different types of lenses) about what kind of vision you want going forward and how he or she thinks that might best be achieved. Remember, the best lens is the one you were born with so hang onto it for as long as you can.

[@shafiqhossain6333]

@@LKearns Thank you for your reassurance. I do have have high level of astigmatism and I believe the doctor mentioned that the length of cornea is slightly longer than average. I'm just hoping the laser incision does correct my astigmatism but am not confident it will since the doctor mentioned he may still need to make post surgery adjustments to correct my astigmatism. Did you go for your second adjustment yet? I would be really interested in what your experience and thoughts were from that appointment.

[@LKearns]

No second adjustment yet. I want my eyes to completely settle before taking another step. As far as I know, the LAL is quite good at correcting astigmatism up to 2.5-3.0 D. If your astigmatism is greater than that, you are correct, your doctors can often do some touch-ups with a corneal incision or laser vision correction. Here's hoping for your best results! Keep me in the loop.

[@annnelson965]

This was interesting. I'm getting my first LAL end of next week. I'm excited and nervous that I'll end up dissatisfied. Watching all these vids has taught me to temper my expectations. I have mild astigmatism and get starbursts and halos because of it. I was hoping that would go away.

[@LKearns]

Here's hoping for a very positive outcome for you. Remember, everyone's eyes are different, and mine have had several surgeries, were highly myopic, etc. In other words, they were complicated. LALs can be very good at correcting many astigmatisms. However, some may be very tricky and coming from an intricately irregular cornea, which the LAL may not be able to correct. But you won't know until you try! Another thing I have learned is to take my time between surgery and light adjustments if you're struggling. Give your eye and your brain time to heal and get used to the new vision/neuro adapt. Be patient. Keep me in the loop and let me know how it goes. I'll be sending you good thoughts.

[@DebRiddle-do4th]

I had a mild astigmatism as well; the starbursts are gone! I hope you have the same result!! This is by far the most fascinating experience I have had so far, I'm 72 years old

[@LKearns]

@@DebRiddle-do4th I'm so happy for you!

[@annnelson965]

@@DebRiddle-do4th had my first eye done 12/19. Was iffy the 1st couple of days but am much improved now. I can see better out of that eye for all distances (except very close up) than I have since I was young. Can't wait for the next surgery on 1/2. I'm feeling really good about the process.

[@TheNoTillGardener]

Would love to know how your surgery turned out. Wishing all the best for you.

[@11111Rich]

Great video with excellent explanations. I am hoping that your starburst is from dry eyes that will improve with time. Could be astigmatism is another thought. Will be following to see what you find out it is

[@LKearns]

Thank you for the kind words, Rich. We are definitely gonna check out all the things you mentioned above. Fingers crossed!

[@billbecker5357]

I had my first treatment last week and like you I don't see much change at all. Near requires reading glasses. Mid (computer monitor) is horrible. I have to put my face right in front of the monitor with readers. So far, I'm unhappy, especially because I feel I was misled. Curious as to where your second treatment video is.

[@LKearns]

No second light adjustment yet. Trying to work out some issues with starbursts and double vision. Until my doctors and I have a clearer understanding of what's going on, I've put further adjustments on hold. I think patience with these lenses is often required.

[@Tee-duck]

@@LKearns. Knowing what you now know. Would you now not recommend LAL?

[@ChrisS-wi2sc]

Thanks for these videos. Question: did you get the RXsight LAL or LAL+ lens? I had the Panoptix implanted about 9 months ago in my left (dominant) eye and my surgeon is now recommending the LAL+ for my right because I’m very “particular” (his word) about my vision. He told me that the LAL+ lens is like the Panoptix, a multifocal, good at all distances with the benefit of being able to dial in the focus after the surgery. I’m a bit concerned after watching your experience. FYI, I’m mostly happy with the Panoptix with the exception of haloes at night and a gap in clarity at computer screen (or vegetable chopping) distance.

[@LKearns]

I received the RxSight LAL. As I understand it, many Ophthalmologists these days are using the LAL rather than the LAL+ for patients with rather complicated ocular histories like mine - LASIK with enhancements back in 1995, vitrectomy with ERM peel in 2023, etc. They believe it appears to react more predictably during enhancements. It's still too early to say what my outcome will be, but as of today I have good distance vision in my LAL eye (probably as good as that I can achieve) but not much near. Still havestarbursts, but testing reveals it's probably coming from my cornea rather than the lens. Problem now has been some diplopia or double vision. I had mono vision/blended vision for 30 years after LASIK without difficulty, but my brain is having trouble neuroadapting to the disparate images coming from my right eye and my left eye at present. A problem we are still working on before proceeding. Remember, everyone's eyes are very different and I think everyone's response to the LAL lens is different, but I still believe it was the right choice for me. The best of luck to you!

[@ChrisS-wi2sc]

@ Thanks and good luck.

[@TonyPadgett]

Just curious, are you a professional presenter? The production of your videos are great and the way you present is like a news reporter. I hope you starbursts go away unlike my experience. I think the LAL technology is too new and the videos out there are over hyping the results. If you don’t mind, I’m going to link your video In mine. People should get a balanced view (no pun intended) about LALs.

[@LKearns]

Thank you for the compliment, Tony. I am a self-taught videographer although 35 years ago I did work in radio news. Flashing back to my early adulthood. And yes, feel free to link. The more information we can all share the better.

[@TonyPadgett]

@@LKearns I should have had you edit my video! :) Interesting the doctors allowed you to video everything. I should have asked that but thought they would say no. BTW, I did contact RxSight about the starbursts, in short, they say that the FDA study showed the same rate of occurrence of visual phenomenon that was lower or equivalent to the control monofocal IOLs.

[@LKearns]

@@TonyPadgett indeed my doctors are amazing. They really believe in sharing information like I do. And interesting what RxSight had to share. That is apparently what the data show. Hopefully there is still something they can do for me and if not we will become part of the outliers.

[@SharonSews]

@@TonyPadgett I also started seeing huge starbursts after my first adjustment of these lenses. It’s been six months with no solution yet, which of course has been quite frustrating.

[@TonyPadgett]

@@SharonSews Sorry to hear that. Last week, I got my right LAL replaced with a monofocal lens. WAY better. Indoor glare is practically gone. Starbursts outside has reduced from 8-10 to just 2 small thin ones. It’s only been a week so I am hoping there might be further improvement. I hope to publish a video about the replacement procedure in a few weeks after I see if things improve. I will say, though, that the replacement surgery was way more rigorous than the first cataract surgery and costs were not covered by insurance.