New Article on LAL

Eye care
1

Everything I read about the LAL is positivie. Only time will tell, but I could see in time this IOL becoming the “New” standard monofocal IOL. According to this article with this new UV coated LAL you might not even have to wear those special UV blocking glasses, which begs the question, “With this IOL could you not do the final lock-in of the lens”?.

Imagine a lens that you could change refractiveness over time. I know each time an adjustment is done you use up some of that adjustable material (I forget the proper term) and at some point you would run out of that adjustable material, but still sooooooooooo cool of an idea.

Search for:

“healio UV-coated Light Adjustable Lens ‘is the future”

Also as another poster mentioned their is a new video on youtube dated 5/4/21 with a Panel Discussion. Search on youtube for:

“The Light Adjustable Lens Live Panel Discussion”

One interesting note is the statement that it is better to go slightly hyperopic (opposite of what is typical done) for original target as easier to adjust / shift from plus to minus.

I just found it so interesting how the doctor tells the story of one of his patients and how they keep adjusting his vision as they tried monovision.

The original plan for this patient was originally Plano in one eye and slight monovision with -.5 D in the other eye. Well the patient was not happy, so they ended up doing adjustment to achieve Plano in both eyes and then ended up completely doing a 180 by having the eye that originally was set to Plano adjusted to -.5 D.

Seriously is that the coolest thing ever???

They also mentioned with the LAL they don’t do toric lens very often.

If I was doing a monofocal the LAL is defineately the way I would go even if it meant I had to fly to a place to have it done

Another cool point, with this lens it makes sense to do bilateral surgery as you can adjust both lens post operatively to achieve the best vision possible.

One last comment. I was doing other things while listening to that video so I have to listen again, but I was Shocked, to put it nicely, how they talked about doing the most micro monovision and yet obtaining J2 close vision. Something unique going on there as there is always a sacrifice (there is no free lunch) to get close vision. I defineately want to learn more about this and what that sacrifice really turns out to be.Because on the surface it sounds better than monovision with a standard monofocal. Maybe Ron, who is leaning towards monovison with a monofocal will do some research and let us know.

For me the EDOF effect was a bit too much anecdotal evidence. Need to see a study with a large sample size and defocus curves plotted which also show the standard deviation. Also all other factors like contrast Sensitivity compared to a monofocal.

2

It appears that the RxSight LAL is only available in the US and one site each in Mexico, Germany, and Scotland. Nothing in Canada.

3

Really, since when is the US the first to get a new medical device approved. Must be some reason for this. Is the cost of the equipment a problem or maybe due to socialized medicine in other countries they did not think the demand was high enough for a premium monofocal IOL which needed expensive unique equipment.

Even in that video the doctors mentioned sharing the equipment, (cost sharing) with other doctors in the area.

4

No idea. I just went to the RxSight where they have the map that shows where the service is available. All kinds of flags on the map in the US. There is a link at the bottom that shows international sites, but there are only three. One each in Scotland, Germany, and Mexico. The majority of cataract surgeries in Canada are done under our health care system. The provinces differ slightly but basically they all cover the monofocal lens, but not the toric or any of the multi focal or EDOF.

5

Useless for me unless they add a toric version, I need cylinder of 2 or greater for my left eye’s astigmatism.

6

I think it may be labor intensive and require more patient time with all the adjustments. Give our Canadian medicare system may not be something they pursue here. Who knows. Good to finally here experiences with it.

7

You have to contact a doctor with experience, but they make it sound like they can adjust it so they don’t need a toric IOL. I have no idea.

8

One would think so, but the funny thing is the Ophthalmologist said he charged less for the LAL than he did for Panoptics or other premium IOLs. Go figure!!!

He said they were overall less work and less aggreviation. I think he might have offered lasik for free to unhappy customers and just the time dealing with unhappy customers due to halos and the like.

On the other hand maybe they are affliated with Rxsight. All I know is so far I read a lot of good things about the LAL and if true and things stay consistent with the passage of time, this is a revolutionary game changer for monofocal IOLs.

9

The toric correction is done when it’s in your eye. 2 d is no problem.

10

That is odd. Just only explanation I can think of why Canada has not approved LAL.