EyeWorld India March 2015 Issue

44 EWAP CATARACT/IOL March 2015 The Light Adjustable Lens under the slit lamp Source: Jason J. Jones, MD The Light Adjustable Lens at 1 week postop, during the second adjustment Source: James Lehmann, MD The lens differs from those currently available commercially because it “delivers unprecedented control of the refractive outcome. There is no competition to the accuracy of this technology,” said Jason J. Jones, MD , in practice at Jones Eye Clinic, Sioux City, Iowa; Sioux Falls, S.D.; and Sheldon, Iowa. Only the LAL allows surgeons to correct residual refractive errors “noninvasively after the lens has reached its final position. Using profiled amounts of UV light the IOL can be adjusted according to patients’ expectations and needs,” said Fritz H. Hengerer, MD, PhD , senior head physician and deputy director, Department of Ophthalmology, Goethe University, Frankfurt, Germany. Simply explained, the LAL is implanted in the bag, without any substantial changes to operative by Michelle Dalton EyeWorld Contributing Writer An update on the Light Adjustable Lens In development for more than a decade, a novel lens is inching its way toward U.S. approval A n IOL that promises to consistently deliver a desired refractive result by allowing surgeons to manipulate its refractive power after implantation offers enormous potential. Even with today’s most advanced IOL calculations and formulas, surgeons still encounter refractive surprises. One lens might eliminate those surprises, experts say. The Light Adjustable Lens (LAL, Calhoun Vision, Pasadena, Calif.) was introduced commercially in Europe years ago, and is currently available in Mexico. Calhoun Vision has started the third and final phase of FDA studies in the U.S. technique. Postoperatively, patients wear protective glasses for about 2–3 weeks, returning to the surgeon’s office twice during that time period for UV light-controlled adjustments to the IOL and a final “lock-in” of refractive power. The LAL is the first product William F. Wiley, MD , medical director, Cleveland Eye Clinic, Ohio, said will allow surgeons to meet the high expectations of patients who have paid for a premium lens or laser cataract surgery. “Even with intraoperative aberrometry, we’re hitting about 80% within 0.5 D; with the LAL, it’s closer to 95%,” he said. Dr. Jones said in his hands, “the LAL surpasses LASIK in terms of refractive accuracy. This should be considered with respect to only correcting sphere and cylinder. Additional corrective capabilities are realistic treatments that should be available as the technology continues to evolve.” James Lehmann, MD , in private practice at Focal Point Vision, San Antonio, is likewise enthusiastic about the IOL’s potential. In the current FDA trial, implantation of the LAL has been limited to patients without a history of previous refractive surgery. However, Dr. Lehmann thinks this IOL has great potential in exactly that patient population because “it is in these post- refractive surgery eyes that current formulas fall short and we miss our mark.” Dr. Hengerer uses the lens liberally among his cataract patients and “especially for those post-corneal refractive surgery like LASIK or PRK. IOL calculation in