The Light Adjustable Lens. How Does It Work???

Full video: How to select the BEST LENS IMPLANT for Premium Lens Replacement or Cataract surgery in 2023. • How to select the Best...
The light adjustable lens or “LAL” enables patients to see far/mid and near with minimal halo effect at night when implanted into both eyes.
The LAL works well but involves more visits to our office than all of the other lens implants that we use.
If you choose the LAL, immediately after surgery and for the first 3 weeks after surgery, you will see well far away but will need to use reading glasses. Additionally during the first 2 months after surgery, you will be required to wear these UV blocking glasses during the daytime when outdoors. They don’t need to be worn indoors.
Starting 3 weeks after receiving the LAL, we use this Light delivery device to adjust and customize the focus of the LAL to improve the reading vision in one or both eyes.
So starting 3 weeks after receiving the LAL, in addition to seeing clearly far away without glasses you start seeing better close-up and at mid-range. We adjust the focus, have you test drive your vision in the real world for one week, then if another treatment or two is needed adjust how you see, we perform another LDD treatment to help you see your best at all distances far/mid and near. Once you like your vision, we then “lock-in” the setting of the LAL’s and your vision is then permanent and you can discontinue use of these UV blocking glasses 24 hours after your final lock-in treatment from the LDD.
Patients with the LAL generally will have one eye set to see better far and mid-range and the other eye slightly offset to see better mid-range and near. The target refraction is generally plano for the dominant eye and between -0.75 and -1.00 for the non-dominant eye. This difference between the eyes is significantly less than “monovision” where the eyes are different by between 1.5 and 2.0 diopters. The difference between the two eyes with the LAL is referred to as “blended vision” which is very well tolerated and performs better than monovision.
So, for patients that want full range of focus and minimal night halo, the LAL works great. For patients that have had success with monovision with contact lenses, the “blended vision” with the LAL works even better than monovision.
I have no financial interest in the light adjustable lens or RxSight. This is not a paid sponsorship.

[@chelsealandreth3574]

I scribe for Dr Stonecipher. We are located in NC. Just found out today we are starting it Friday after years of him saying no😂 I’m trying to learn as much as possible. I always tell him I watch your videos ! So informative

[@ShannonWongMD]

Karl Stonecipher is an outstanding human being and ophthalmologist! Thank you for watching!

[@stanstephen3853]

Getting my first post surgery light adjustment this week and hoping it all turns out how this video explains it. So far the vid. Is pretty much spot.

[@Computerfly]

How did it go? Have your adjustments yet?

[@Destination360]

report?

[@tigresa821]

I would never think of a lens like this. Panoptix was great for me.

[@shauns5680]

Comparison to blended vision with Vivity?

[@elizabethallen1415]

How do the eyes adjust to the "blended" vision? Do things look wonky or clear whether far or near?

[@terriem3922]

It is the only lens I would consider, because it is made of a material I am not allergic to. Also, I would like 20/20 vision. But my entire iris is 6 mm, so I can't wear it. Maybe I will never get cataract surgery. I see pretty well with glasses.

[@michee_veez2480]

For a radiologist would you generally say that this would be the best lens type ?

[@tipsandtricks2974]

Dr i am going to operate please suggest me i am 37years old what are the best lens for me vivvity lens or lal lens are best or some other please doctor guilde me i shall be thankfull to you forever

[@JeremyCouch]

It sounds great and I did consider it before my surgery last year. I love my Panoptix lenses for the most part, but I do really dislike the halos (mine are worse than what most people experience it seems). That said, I wonder how people tolerate having different vision in each eye. I'd probably adapt I suppose but just thinking about it makes me a bit disoriented. 🙃 Is the explanation or exchange rate as low as other premium IOLs so far?

[@mikethomas4210]

I have Panopitx in both eyes too. Besides needing to be glasses-free what I liked was if for some reason one of my eyes was unable to function, my other eye would be able to see exactly the same as with both eyes.

[@tigresa821]

You will become less and less aware of halos. Panoptix are wonderful for me, I would never think of lenses like LAL, I wouldn't want to be going to consultations, I like safety better, especially in the eyes.

[@sandychu9064]

I have had LAL for more than a year, but why does the distance my eyes see change? Is it not locked? After the first three months, I didn’t need to wear glasses to read. Now I can’t see without glasses. Why is this happening? can you tell me? thank you

[@mikeziegler7008]

At 1:15 it is mentioned that "you will see great immediately after surgery" I hope that this does not mean within the first few hours but rather after a day or so. I say this because I had LAL surgery on my left eye this morning. And although my vision is improving bit by bit.... it has been about 8 hours and I am a far cry from "seeing great." Edit: Woke up to much better "distance" vision than I had before the surgery.

[@Computerfly]

How is your vision with LAL?

[@mikeziegler7008]

@@Computerfly I have 20/20 monovision, (one eye is near to mid and the other eye is mid to far). I am very pleased but I highly recommend that a patient be well suited to mono-vision before requesting this outcome.

[@Computerfly]

@@mikeziegler7008 I truly dislike monovision. I realize why they recommend it (so that you can read without readers) but I have never appreciated it using contacts. I always prefer equal distance vision, and will use readers when I need them. Thanks for the info.

[@mikeziegler7008]

​@@Computerfly Some people are better suited to monovision than others. It don't notice a thing unless I close one eye or the other.

[@brianknecht3216]

My doctor recommends bi-lateral surgery for LAL. What’s your option?

[@jetsetjoey]

M research indicates that to have both great far AND near distance with LALs, you must have a degree of monovision, which means you lose some of your depth of focus. Is this correct? I operate heavy equipment & cannot afford to lose any depth of range...

[@--2455]

Hello, I read that with the LAL you can gain some Extended depth of focus IN EACH EYE by targeting HYPEROPIA IN BOTH EYES (so that light treatments are easier this way ; correcting hyperopia steepens the central optic and increases EDOF, allowing more functional near with less myopic defocus). Does this contradict your video, where you target MYOPIA and PLANO to have depth of focus as a result of BLENDED vision (aka minimonovision) and not for each eye individually ? Thanks !

[@ShannonWongMD]

In the non-dominant eye, the light delivery device treatment is designed to extend the range of focus. In the dominant eye, the goal is to target Plano and not target hyperopia.

[@sarahlouie5241]

Dr Wong: Can I replace a one-year-old Vivity Toric Lens with LAL after a recent YAG procedure?

[@ShannonWongMD]

It is possible but complex.

[@tipsandtricks2974]

Why are you replacing toric i am going to operate a cataract surgery can you tell me whats is the best lens for.me

[@speculatorking]

Dr Wong great video. In your opinion, is the LAL going to revolutionize the cataract market, and have the largest share of the market?

[@bestcomment3589]

what do u do if we get starbursts after lal?

[@gz9gjg108]

I foolishly had LASIK, would the LAL work for post-LASIK eyes? I have multiple aberrations and need both eyes to work together to get acceptable vision. Also, why wouldn't you target having both eyes match? I would far rather wear distance glasses for driving OR reading glasses, than to have mis-matched eyes.

[@dmt2k]

Is Lasik generally frowned down upon now? Lasik provided me 20 years of great vision without glasses or contacts. I definitely didn’t know it would limit my IOL options. But even if I did, I think I would have still done it.

[@bestcomment3589]

lens can cause starbursts?

[@MrPetrvershinin]

Any plastic lens in the eye ultimately ends in SECONDARY CATARACT (clouding of the posterior wall of the capsule) 100% after this surgery. THIS is the main thing you need to understand and remember!!! And also know that REMOVAL OF SECONDARY CATARACTS often leads to complications of a more serious nature than primary cataracts and its elimination....

[@bestcomment3589]

what type of complications> I had secondary cataract removal for one eye days after LAL - then developedtarburst in that eye. also you are talking in vast generalities so be specific. @@MrPetrvershinin

[@MrPetrvershinin]

@@bestcomment3589 1) be more specific - WHAT MEANS \ developedtarburst \ ??? 2) what eye tissue is located behind the back wall of the capsule in which a hole is burned with a laser to remove the so-called “secondary cataract” and why PROBLEMS APPEAR like GLAUCOMA and damage to the OPTIC NERVE, which ends in irreversible BLINDNESS... THIS is a specification for complications after burning a hole in the back wall of the capsule....

[@MrPetrvershinin]

about SECONDARY CATARACT and what percentage gets it after implanting a piece of plastic into the eye ....... Аbout the "ADVANTAGES" and SPECIFICATIONS of plastic in the eye - THIS IS NOT AT ALL something to talk about

[@danivision261]

Forgive me for being frank, but think the only thing to discuss here is that without this "piece of plastic", most elderly would be blind for primary or even secondary cataract. But LAL goes much much farther! It's the only existing intraocular lens that, without touching the eye itself, permits laser precise correction of any residual refractive error after cataract surgery. Wished I could have this expensive last generation technology here in Brazil - so I could offer it my own patients! Good luck!

[@MrPetrvershinin]

@@danivision261 "....This is the only existing intraocular lens that, without touching the eye itself,...." ...These are your words from your comment to me - HOW TO UNDERSTAND THIS???? ... an intraocular lens and, right there - which does not TOUCH THE EYE ITSELF - IF THIS PIECE OF PLASTIC IS INSERTED, IT MEANS IT CAME INTO THE EYE!!!!! AGAIN, - make me a HOLE in my natural lens and I WILL CORRECT EVERYTHING REST WITH GLASSES, - it’s SO SIMPLE, - I don’t need monofocal or other “toric” eye plastics... .... OR SUCH SURGERY DOES NOT GIVE THE MONEY that everyone who SINGS SWEETLY IN THE EARS would like to have .....

[@davidfwilliams1960]

it's better than being blind.

[@MrPetrvershinin]

@@davidfwilliams1960 DEAR, 1) what is better or what is worse - THAT is NOT what I am talking about. 2) there is a COMPLETELY different surgery in order not to be BLIND - the problem is the passage of light through the CLAPED LENS OR CORNEA - surgery without a piece of plastic in the eye eliminates this aspect!!!! ... YES, you will need to use glasses, so what???? 3) And the ethically important thing is that 190% of implantation of a piece of plastic into the eye leads to the SAME CATARACT. ... THAT IS, natural cataracts and secondary cataracts created by OUTSIDE HANDS are not the same thing.

[@davidfwilliams1960]

@@MrPetrvershinin I have no idea what you are talking about. There is roughly a 30% chance of secondary cataracts that are easily removed with a Yag procedure. There is no surgery to remove cataracts without replacing with an IOL - not since the 1960's anyway.

[@darcyolson7324]

Define great far vision 🙄