16 EyeWorld Asia-Pacific | March 2025 by Liz Hillman, Editorial Co-Director ‘It’s a learning curve to load it’ There were a few reasons that the ophthalmologists at Baylor were interested in the LAL. “At Baylor, we do a lot of research in IOL calculations and various formulas, but the results are still not perfect. Formulas are around 75% at best, and we have outliers. I really want [LASIK-like outcomes] for our patients. We see a lot of post-refractive patients now, and their expectations are very different,” Dr. Khandelwal said. The academic practice didn’t join the LAL bandwagon right away, however. It was the second iteration of the lens that included ActiveShield, which reduces issues with accidental UV light exposure before lock-in, that made them more comfortable with offering the technology. But it still came with a learning curve. CATARACT Latest Lessons Learned With The Light Adjustable Lens Since its approval in late 2017, many physicians now have several years of lessons learned under their belt, from working with the Light Adjustable Lens (LAL, RxSight). And with the more recent commercial launch of the LAL+, which has a modified aspheric surface to extend depth of focus slightly, ophthalmologists have even more to talk about with this lens platform. EyeWorld spoke with Sumitra Khandelwal, MD, to learn how an academic center brought on the LAL, and also spoke with Bryan Lee, MD, JD, Neda Shamie, MD, and Taylor Strange, DO, private practice ophthalmologists, to understand their diverse perspectives and experiences to do with this lens. “The real questions when we started to analyze this technology were 1) how were we going to incorporate it in our practice, which is different from a private practice, and 2) is this technology going to cannibalize some of the premium technologies we already use?” she said. “Those are two questions I think everyone has to ask themselves about the Light Adjustable Lens. Personally, I’ve found myself pleasantly surprised by both.” Dr. Khandelwal said the LAL hasn’t taken away from other advanced-technology lenses, rather it’s augmented their offerings. “It’s opened up the space for patients who we may not previously have considered as great candidates for a presbyopia-correcting lens.” From a clinic flow standpoint, Dr. Khandelwal said it’s been helpful to have their research optometrist trained in
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