Answers by Dr. Mitchell Gossman, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud
What is the Light Adjustable Lens for cataract surgery about?
In short, the Light Adjustable Lens (RxSight, Aliso Viejo, CA) is a newly available lens implant for cataract surgery that can be adjusted with light (UV light) after surgery, in a painless office procedure, to provide the best possible vision without glasses. This procedure is available at Eye Associates of Central Minnesota in St. Cloud.
Cataract surgery is removal of the cloudy natural lens in our eyes that occurs with aging, and replacing it with a clear artificial lens. The primary goal is improved vision, but the vision without glasses might also be better than before surgery if the glasses prescription strength is less. Very few people end up with zero prescription after cataract surgery.
The outcome patients want is very little glasses prescription, ideally so that 20/20 vision is achieved without glasses. The reason that most people don’t see 20/20 without glasses after surgery is that, unfortunately, methods to calculate the ideal power of a lens implant are not perfect, providing only an estimate of the power of the artificial lens that will result in zero glasses prescription after surgery. Most people need bifocals to see without glasses with a regular lens.
The Light Adjustable Lens changes all this. This lens is placed inside the eye much like any other lens implant, with an estimated power, but after surgery we’re able to adjust the power of the implant to reduce or eliminate the leftover prescription. It’s rather like getting the golf ball on the green with the driver (surgery with estimated lens implant power) and then getting to get it to the hole with a putter (the power adjustments). In a way, it’s like performing “LASIK surgery” on the lens implant, without the invasiveness, risks, and side effects of LASIK.
With a standard lens implant, only 20 percent of patients see 20/20 without glasses after surgery. Studies have shown that with the Light Adjustable Lens almost 80 percent of patients see 20/20, 25 percent even see better than 20/20, and with both eyes working 92 percent see 20/20. A goal for many is “driving vision” which requires 20/40 or better vision in at least one eye, and more than 99 percent achieve this.
This lens has proved to be safe and effective in FDA clinical trials going back to 2005, and has recently become available to patients.
Not only does the lens significantly improve the vision without glasses compared to a standard lens, but it opens the door to being able to “test drive” your vision. Most people opt for at least one eye to be focused at distance, and have the second eye set for reading. The distance at which print and objects are in focus for the second eye can be adjusted after surgery, so you can “fine tune” your focal point. This lens also (via means too complex to describe here) provides a better range of vision, “depth of focus,” that a standard lens.
There are some things to be aware of if you are wanting to go with this lens:
1. The lens and surgical management unique to this lens is not covered by insurance. Health savings accounts funds can be used, and financing is available. Normally, the cataract surgery itself is a covered medical expense (except applicable deductibles).
2. The lens is adjusted with ultraviolet light, so special UV-protective eyewear must be worn at all times until the last adjustment is done. These glasses, and the adjustments, are included in the cost.
3. Not all patients are eligible, for instance if your eye measurements are outside the power and adjustment range of the lens, and other factors. Most, however, are eligible.
If you have further questions, you can call our office, or discuss at your cataract surgery evaluation.
Find out more
Dr. Mitchell Gossman is a comprehensive ophthalmologist, along with Dr. Melanie Thares, an optometrist, at Eye Associates of Central Minnesota. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email info@eaofcm.com.
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