RxSight Light Adjustable Lens
The Next Evolution of the Light Adjustable Lens
RxSight has enhanced the safety and predictability of their Light Adjustable lens by adding a layer of UV-protection to their groundbreaking intraocular implant. Patients achieve uncompromisingly clear vision and customize their visual results. ActivShield preserves the power and versatility of this technology.
Imagine an implant that can be fine-tuned after cataract surgery. An intraocular lens that can be precisely adjusted to your refractive needs. The Light Adjustable Lens is the breakthrough technology patients and surgeons have been demanding for years. A 90 second in-office “tune-up” eliminates astigmatism and customizes the lens to a perfect focus. This implant is ideal for post-LASIK patients, those who prefer monovision, and individuals who want the sharpest possible vision.
The specialized silicone of this implant can be modified using medical grade Ultraviolet (UV) light. Any deviation from target can be corrected after the eye has healed. Furthermore, you can test drive the refractive results and choose the endpoint that satisfies your visual needs.
Three Light Adjustable Lens (LAL) Patients
AR was a near-sighted engineer whose cataracts were making driving difficult at night. He longed to eliminate his glasses but wanted to avoid the haloes experienced by his friend who had had a multifocal implant. He choose perfect distance vision in both eyes without glasses using a LAL. After his first adjustment he was thrilled with “the best distance vision he had ever experienced” but wanted more near. The second adjustment gave him freedom from glasses for almost all activities and he elected to lock-in. He had un-compromised distance vision for all activities and was glasses-free for all near tasks except for the reading of technical manuals. The LAL allowed this patient to refine his goals and achieve his best result.
LM enjoyed glasses free vision with monovision contact lenses until her cataracts developed. She elected to continue her monovision when a PanOptix was ruled out when her macular pucker was identified. Following her first adjustment LM wanted even more reading vision than she had enjoyed with her monovision contacts. After her second adjustment she said, “perfect, now… lock me in”.
CV required glasses for distance and near once she reached middle age. After her cataracts developed she sought freedom from glasses. Her astigmatism made a LAL her best option. After her first adjustment her distance and intermediate vision were excellent but she wanted more clarity for reading. After her second adjustment she requested “just a little bit more reading”. She achieved her ideal personalized refractive solution following her third adjustment and now enjoys reading and driving without glasses.
Unlike any previous intraocular lens, the LAL gives surgeons the ability to achieve their patient’s refractive goals precisely. The LAL gives patients the ability to design and re-design their refractive endpoint.
Monovision Contacts versus the Light Adjustable Lens (LAL)
Until now, surgeons been unable to achieve the accuracy of monovision after cataract surgery that patients enjoyed before their cataract developed. Despite the most advanced pre-operative and intra-operative techniques, the best cataract surgeons can not calculate an implant power with the same accuracy as contact lenses.
The LAL gives doctors and patients the same accuracy as contact lenses with a non-surgical opportunity to experiment and finally select the ideal reading distance. Many surgeons also feel the LAL provides an extended depth of focus that outperforms contact lens monovision.
For monovision patients who develop cataracts, nothing can compete with the safety, flexibility, and precision of the LAL.
Former LASIK patients and the Light Adjustable Lens (LAL)
Cataract patients who have had previously LASIK surgery are less likely to achieve 20/20 glasses-free vision than cataract patients who never had LASIK. This discrepancy arises from the inability of modern implant calculation formulae to precisely determine the correct implant power in the post-LASIK eye. The LAL addresses the unique challenges of former LASIK patients. In fact, patients with an LAL are twice as likely to achieve 20/20 glasses-free vision as patients with any other intraocular implant.
We prefer the LAL in patients with previous LASIK because we can match and often exceed their refractive expectations
Frequently Asked Questions
The unique feature of the Light Adjustable Lens is that the shape and focusing characteristics can be changed after implantation in the eye using an office-based UV light source called a Light Delivery Device or LDD. The Light Adjustable Lens itself has special particles (called macromers), which are distributed throughout the lens. When ultraviolet (UV) light from the LDD is directed to a specific area of the lens, the particles in the path of the light connect with other particles (forming polymers). The remaining unconnected particles then move to the exposed area. This movement causes a highly predictable change in the curvature of the lens. The new shape of the lens will match the prescription you selected during your eye exam.
Please follow all instructions provided to you by your eye doctor and staff, including wearing of the UV-blocking glasses that will be provided to you. As with any cataract surgery, your vision may not be perfect after surgery. While your eye doctor selected the lens he or she anticipated would give you the best possible vision, it was only an estimate. Fortunately, you have selected the Light Adjustable Lens! In the next weeks, you and your eye doctor will work together to optimize your vision. Please make sure to pay close attention to your vision and be prepared to discuss preferences with your eye doctor.
The UV-blocking glasses you are provided with protect the Light Adjustable Lens from UV light sources other than the LDD that your doctor will use to optimize your vision. Exposing the Light Adjustable Lens to other UV light sources will potentially change the lens correction in an uncontrolled manner. If you do not wear the provided UV-blocking eyewear, your vision may not improve or it could get worse. If this happens, the Light Adjustable Lens may have to be removed or replaced with a new lens to improve your vision.
The UV-blocking glasses must be worn at all times until your eye doctor tells you that you no longer need to wear them (usually 24 hours after your final light treatment). Total wear is typically about 4-5 weeks in duration, however, this may vary depending on the number of light treatments delivered.
I have a special event to attend in-between light treatments, do I really have to wear the UV-blocking glasses?
Yes, you must wear them all waking hours to prevent uncontrolled changes to the Light Adjustable Lens. It is important to think about the time period over which you must wear the UV-blocking glasses and any commitments that you may have. It may be best to schedule your surgery and treatments around these commitments.
No. You must wear the UV-blocking glasses provided to you. These glasses have a special protective coating that no other glasses have.
You must wear the dark pair of UV-blocking glasses during daylight hours, even if it is overcast. The clear pair can only be worn outside after sundown.
Please notify your eye doctor/clinic as soon as possible if one of your two pairs of UV-blocking glasses are lost, damaged or unwearable, and then continue to wear the other pair. If both pairs are lost or damaged, wear the darkest sunglasses you have and contact your eye doctor/clinic immediately.
Showering – If there is a window or possible direct sunlight in your shower, please wear the UV-blocking glasses in the shower. If there is no direct sunlight, you do not need to wear your UV-blocking glasses when you shower. However, please put them on immediately afterwards.
Sports – Your eye doctor will advise you when you can return to sports. Your return to more impactful activities may need to be delayed until all light treatments are complete to guarantee a stable Light Adjustable Lens for light treatments.
Tanning Studio – A tanning studio bed is a very strong source of UV light, and should be avoided until all light treatments are complete and you have been advised that you can remove your UV-blocking glasses.
Make Up – Your eye doctor will advise you when you can return to wearing eye make-up. Be careful when removing eye make-up and do not place excessive pressure on the eye. Permanent make-up should be delayed until the eye is considered fully healed by your eye doctor.
Travel – Travel is not impacted. Be sure to remember all of your UV-blocking glasses and wear at all times. Be particularly diligent in protecting the eyes from UV sources in unfamiliar environment.
Work – Work is not impacted, unless your profession puts you at a higher risk of UV exposure. Please remember to wear your UV-blocking glasses at work until you are told by your eye doctor that it is no longer necessary.
Laser Hair Removal – It is recommended that you wait until all light treatments are complete and you have been advised that you can remove your UV-blocking glasses before proceeding with hair removal (IPL) treatments (different IPL devices use different wavelengths). This should include other facial beauty treatments that use light sources.
It is very important that you do not forget to wear your UV-blocking glasses. However, if you do forget – please put them on as soon as you remember. Note how long you were without the glasses and the light conditions during this time, and then contact your eye doctor/clinic immediately.
You will need a minimum of two treatments, and a maximum of five. The total number is dependent on your eye doctor’s plan for your vision, as well the amount of UV light delivered at each treatment.
Each light treatment will last between 8 and 120 seconds, with the average being approximately 90 seconds. Variation in time is dependent on the type of treatment performed.
Numbing drops will be applied to your eye, and there may be some mild-pressure or discomfort. However, the light treatments should not be painful.
Your vision may be blurry immediately after each treatment due to a gel used during application of the light treatment, but this should resolve quickly. Additionally, your eye may be dilated for the treatment which may require wearing tinted glasses for a few hours. It may take approximately 24 hours after each light treatment to notice an improvement in your vision. The light from the LDD may also cause a temporary or long-lasting pink or red afterimage, which is common with a light source directed to the eye. This tinge to your vision is especially noticeable on things that normally look white.
Our RxSight LDD (light delivery device), shown below, resembles a standard office slit-lamp. It is computer driven and comfortably adjusts the Light Adjustable Lens to your specifications.
Our best pre-operative intraocular lens power calculation techniques are woefully inadequate. The graphic below, from an award winning paper, shows deviation from the ideal implant power using scattered error values. The innermost sphere encloses calculations whose power is off by less than 0.5 diopters. Greater than 15% of cases are greater than 0.5 diopters from optimal.
The graphic below shows 1000 patient calculations and their resulting deviation from optimal. Nearly 5% of patients are more than 1.0 diopters from ideal. The Light Adjustable Lens allows all patients to be enhanced and the scatter to be dramatically tightened and their refractive errors reduced. The RxSight Light Adjustable Lens should correct all patients to +/- 0.25 diopters from target. Furthermore, this technology eliminates errors from residual astigmatism.
While normal eyes generate a scatterplot like the one shown above, patients with a more complex cornea (LASIK, dry eye, longstanding contact lens wear, and irregular astigmatism) have even less predictability. Because the Light Adjustable Lens can minimize these errors, it is ideal for these special cases.
Toric Versus Light Adjustable Lens
The Light Adjustable Lens (LAL) provides a more exact refractive result than a TORIC implant. Even the best surgeons will fail to correct all of your astigmatism with a TORIC. Pre-operative calculations are imperfect, intra-operative measurements are suboptimal, implants can rotate, and your eye’s healing is not always predictable. What is considered a success in a TORIC implant is the starting point for refinement with a LAL. Furthermore, this new technology can help patients in which the magnitude and direction of astigmatism is more difficult to determine pre-operatively. While more expensive, the LAL provides a more rewarding solution for our cataract patients.