Aa
LAL IOL claims perfection or LI61AO
My doc uses the LI61AO which is 3 piece, with PMMA haptics. I didn't do well with the monovision contacts and there was a focus gap right at computer screen distance (I work with computers) so we'll go for distance and was told that unless there was some kind of miracle, I'd be using bifocals (which I could live with right now I'm carrying two pairs of reading glasses).
So now I'm hearing about the Light Adjustable Lens, and the claims from the manufacturer say you don't need glasses at all, which is attractive. So the decision to wait, do something now, and maybe have them replaced later.
Is there any indication that the LAL's really can be tuned so you don't need glasses?
How hard is it to remove a LI61AO silicone lens if the LAL turns out to be a miracle cure?
thanks!
So now I'm hearing about the Light Adjustable Lens, and the claims from the manufacturer say you don't need glasses at all, which is attractive. So the decision to wait, do something now, and maybe have them replaced later.
Is there any indication that the LAL's really can be tuned so you don't need glasses?
How hard is it to remove a LI61AO silicone lens if the LAL turns out to be a miracle cure?
thanks!
I don't believe I have any lenticular astigmatism because I don't have any residual astigmatism doing an over refraction wearing my rgps which masks up to 3 diopters of corneal astigmatism because of the tear layer filling in the irregularities. In the past when I have been out of contacts for a stretch my refractions have always shown none in the left and about 1.50 in the right.
That is one reason I hestitate to go to a toric IOL is because if the power is off, the astigmastism in the IOl shows up when an RGP with a spherical base wipes out the corneal astigmatism and toric contacts despite improvements are not all that great. The LAL avoids this concern because you are very unlikely to end up more that .5 +- from plano.
I have confidence in the LAL, I just don't like taking a month to get it adjusted the way I want it. I have always been able to get really good vision with RGP's and really want to be able to go back to them in the event of a major surprise in refractive error.
That is one reason I hestitate to go to a toric IOL is because if the power is off, the astigmastism in the IOl shows up when an RGP with a spherical base wipes out the corneal astigmatism and toric contacts despite improvements are not all that great. The LAL avoids this concern because you are very unlikely to end up more that .5 +- from plano.
I have confidence in the LAL, I just don't like taking a month to get it adjusted the way I want it. I have always been able to get really good vision with RGP's and really want to be able to go back to them in the event of a major surprise in refractive error.
Of course results will vary with each individual so there is no guarantee. The best guidance is the average results from studies, but to be prepared you might be a bit worse than average. It takes less acuity than you might guess for some print sizes, I ran into this link which lists the acuity required for various print sizes:
http://www.teachingvisuallyimpaired.com/print-comparisons.html
My 20/25 at near is at best near distance, rather than the 40 cm they often test at, but it lets me read the fine print on my eye drop bottles (though I need to hunt for the right distance to hold it at further out, it is like early presbyopia with small print). I don't know how much the age of the rest of the visual system matters, since I got my IOLs younger than usual, at 52 (though I'm guessing that you are also younger than typical since younger patients seem the ones more inclined to spend some effort to find the best option).
I figured if my intermediate were worse than the average result with a trifocal then it might be more of a concern than a slight drop with the Symfony. I preferred if I needed glasses for anything, to need them for near since I usually wouldn't need that outside of home/office. I haven't ever had a need to carry around readers, but I discovered at Barnes&Noble they sell foldup readers that fit in your pocket if there is an occasional need.
Once concern I had with LAL using the custom multifocal or extended depth of focus patterns was that it hadn't yet been done with lots of patients. I'm an early adopter and realized that even the Symfony was fairly new when I got it, but I wasn't sure that the LAL patterns might be a little too new for me, there wasn't yet anything published on it. I figured that even though the optics of the Symfony were new, at least the lens itself was the same widely used material as all Tecnis lenses, and presumably a similar manufacturing process to the Tecnis multifocals.
If your other eye won't be done for a while, there are other lenses you might keep an eye on. There are now some other extended depth of focus lenses that are CE marked but don't seem to be being widely marketed yet and there isn't as much data on them to know how they compare, like the SF Medtech Mini Well (which in 1 optical bench test at 1 aperture size did slightly better than the Symfony, but I don't know how it compares in real use yet), and the WIOL-CF (which one surgeon commented via email he was concerned about due to its lack of regular haptics, that they hope it stays in place by filling the lens capsule), and the RevIOL tri-ed trifocal which supposedly combines a bit of enhanced depth of focus with the trifocal to smooth the defocus curve.
re: "Plus the LAL can knock the 1.50 cylinder in my second eye. Don't have that issue in my cataract eye."
Of course they can also address that with incisions and/or a toric lens. I don't know if you are basing your assumption the other eye doesn't need astigmatism correction on your prescription, or if you've had the measurements taken for an IOL. The issue is whether you do know how much corneal astigmatism you have. Although it isn't that likely, its possible that you have lenticular astigmatism in the opposite direction balancing some of your corneal astigmatism, and of course that goes away when the natural lens is removed.
One thing to be aware of is that doctors used to have equipment that just measured the anterior astigmatism, since their equipment focused on measuring the surface of the cornea. Doctors started noticing residual astigmatism they didn't expect after surgery, and realized that the posterior astigmatism can make a difference and so its best to be sure that they have measured both anterior and posterior astigmatism.
http://www.teachingvisuallyimpaired.com/print-comparisons.html
My 20/25 at near is at best near distance, rather than the 40 cm they often test at, but it lets me read the fine print on my eye drop bottles (though I need to hunt for the right distance to hold it at further out, it is like early presbyopia with small print). I don't know how much the age of the rest of the visual system matters, since I got my IOLs younger than usual, at 52 (though I'm guessing that you are also younger than typical since younger patients seem the ones more inclined to spend some effort to find the best option).
I figured if my intermediate were worse than the average result with a trifocal then it might be more of a concern than a slight drop with the Symfony. I preferred if I needed glasses for anything, to need them for near since I usually wouldn't need that outside of home/office. I haven't ever had a need to carry around readers, but I discovered at Barnes&Noble they sell foldup readers that fit in your pocket if there is an occasional need.
Once concern I had with LAL using the custom multifocal or extended depth of focus patterns was that it hadn't yet been done with lots of patients. I'm an early adopter and realized that even the Symfony was fairly new when I got it, but I wasn't sure that the LAL patterns might be a little too new for me, there wasn't yet anything published on it. I figured that even though the optics of the Symfony were new, at least the lens itself was the same widely used material as all Tecnis lenses, and presumably a similar manufacturing process to the Tecnis multifocals.
If your other eye won't be done for a while, there are other lenses you might keep an eye on. There are now some other extended depth of focus lenses that are CE marked but don't seem to be being widely marketed yet and there isn't as much data on them to know how they compare, like the SF Medtech Mini Well (which in 1 optical bench test at 1 aperture size did slightly better than the Symfony, but I don't know how it compares in real use yet), and the WIOL-CF (which one surgeon commented via email he was concerned about due to its lack of regular haptics, that they hope it stays in place by filling the lens capsule), and the RevIOL tri-ed trifocal which supposedly combines a bit of enhanced depth of focus with the trifocal to smooth the defocus curve.
re: "Plus the LAL can knock the 1.50 cylinder in my second eye. Don't have that issue in my cataract eye."
Of course they can also address that with incisions and/or a toric lens. I don't know if you are basing your assumption the other eye doesn't need astigmatism correction on your prescription, or if you've had the measurements taken for an IOL. The issue is whether you do know how much corneal astigmatism you have. Although it isn't that likely, its possible that you have lenticular astigmatism in the opposite direction balancing some of your corneal astigmatism, and of course that goes away when the natural lens is removed.
One thing to be aware of is that doctors used to have equipment that just measured the anterior astigmatism, since their equipment focused on measuring the surface of the cornea. Doctors started noticing residual astigmatism they didn't expect after surgery, and realized that the posterior astigmatism can make a difference and so its best to be sure that they have measured both anterior and posterior astigmatism.
Thanks for those stats on your results. I would be elated with 20/25 distance and newspaper reading laying flat on the dinner table, 16 inches on the smartphone would be stellar and I would be fine even at 20-22 inches. If I could read most things with my arm crooked to about a 130-140 degree angle( with 180 being straight) I would definitely be better off with the Symfony. My cataract eye is actually my dominant eye but since my cataract has been making that eye progressively more nearsighted I know that I can handle either eye being the near eye in a .5 mini mono setup. I may have him target the first eye for distance and if we miss a little myopic I can live with it I f we hit the mark on the second eye. If we hit it on the first eye I will probably go for a minimono with the symfony on the second. If we miss on the first I think I will endure the LAL adjustments and end up with a very compatible system in the second eye with little chance of missing the desired refraction and extended focus. Plus the LAL can knock the 1.50 cylinder in my second eye. Don't have that issue in my catarct eye.
I am thinking that because I am already used to using asphericity on my RGPs to have extended focus near and intermediate (with a center 2mm distance zone) I have a decent chance of getting the RGP to work well with the symfony as long as the image sizes don't differ too much.
I am thinking that because I am already used to using asphericity on my RGPs to have extended focus near and intermediate (with a center 2mm distance zone) I have a decent chance of getting the RGP to work well with the symfony as long as the image sizes don't differ too much.
You could consider switching to glasses beforehand, or soft contacts so you need to leave them out less time before the surgery.
I read my smartphone (4.7" screen, Android) at what seems to be a typical distance to hold it, perhaps 14-16 inches taking a quick measure now (I thought I measured it a bit different before but I hadn't checked), the web browser does blur closer in than that. I don't have a hardcopy paper here to check distance, I only read hardcopy news when out of the house, but I've had no trouble with Wall Street Journal & New York Times size print resting the paper normally on the table at a Starbucks. Yup, each of my eyes test separately as at least 20/20 at distance (last check they didn't check to see what the acuity was, just that they were at least 20/20). My hyperopic eye subjectively seems a bit better at distance (likely due to lack of astigmatism), it might be 20/15 or so. You can be a little myopic, or have a little astigmatism, and still hit 20/20 with the Symfony.
With the Symfony I would suggest -0.5D mini-monovision makes sense, its possible I may consider a laser tweak to bring my hyperopic eye to -0.5D. That puts the best focus for that eye at 2 meters, and still leaves some distance vision beyond that and shouldn't impact stereopsis much since for most ranges both eyes have good vision. The idea of getting a tweak though is mostly since it seems a waste to be hyperopic, not that I really have felt a need for more near. I'm hesitant to risk any reduction in the great distance vision I have, even if it would still be at least 20/20. I admit wondering what the added near of a trifocal would have been like, but I think it was a good tradeoff to go for the better intermediate since we use it for so many things, from the computer to social distance to household tasks, to even walking, though its not clear how noticeable the difference would be really with the trifocal. The charts I saw comparing the AT Lisa Tri with the Symfony showed more of a drop for intermediate for the trifocal than I'd seen in other papers on the AT Lisa Tri, though all the charts show some drop.
I've recently been out hiking more on rocky (and snowy/icy) trails and appreciating the fact that intermediate vision is useful for planning footing and spotting black ice (especially since I will be switching to running soon). I appreciate having a crystal clear 3D image of rocks on the trail, I'd be curious whether the reduced steropsis with monofocals and full monovision would have increase the chance of misplaced footing and falling much, or if using mostly one eye for that distance would reduce the chance of spotting a bit of ice. (during the brief time I did monovision with contacts, before switching to multifocals, I wasn't out on trails at all to have thought of the issue).
I read my smartphone (4.7" screen, Android) at what seems to be a typical distance to hold it, perhaps 14-16 inches taking a quick measure now (I thought I measured it a bit different before but I hadn't checked), the web browser does blur closer in than that. I don't have a hardcopy paper here to check distance, I only read hardcopy news when out of the house, but I've had no trouble with Wall Street Journal & New York Times size print resting the paper normally on the table at a Starbucks. Yup, each of my eyes test separately as at least 20/20 at distance (last check they didn't check to see what the acuity was, just that they were at least 20/20). My hyperopic eye subjectively seems a bit better at distance (likely due to lack of astigmatism), it might be 20/15 or so. You can be a little myopic, or have a little astigmatism, and still hit 20/20 with the Symfony.
With the Symfony I would suggest -0.5D mini-monovision makes sense, its possible I may consider a laser tweak to bring my hyperopic eye to -0.5D. That puts the best focus for that eye at 2 meters, and still leaves some distance vision beyond that and shouldn't impact stereopsis much since for most ranges both eyes have good vision. The idea of getting a tweak though is mostly since it seems a waste to be hyperopic, not that I really have felt a need for more near. I'm hesitant to risk any reduction in the great distance vision I have, even if it would still be at least 20/20. I admit wondering what the added near of a trifocal would have been like, but I think it was a good tradeoff to go for the better intermediate since we use it for so many things, from the computer to social distance to household tasks, to even walking, though its not clear how noticeable the difference would be really with the trifocal. The charts I saw comparing the AT Lisa Tri with the Symfony showed more of a drop for intermediate for the trifocal than I'd seen in other papers on the AT Lisa Tri, though all the charts show some drop.
I've recently been out hiking more on rocky (and snowy/icy) trails and appreciating the fact that intermediate vision is useful for planning footing and spotting black ice (especially since I will be switching to running soon). I appreciate having a crystal clear 3D image of rocks on the trail, I'd be curious whether the reduced steropsis with monofocals and full monovision would have increase the chance of misplaced footing and falling much, or if using mostly one eye for that distance would reduce the chance of spotting a bit of ice. (during the brief time I did monovision with contacts, before switching to multifocals, I wasn't out on trails at all to have thought of the issue).
My trip to Tijuana from Houston is not too expensive, under $500 for airfare and hotel plus my meals for four days. Because I am wearing RGPs and only taking one out for four weeks prior to the trip so I can function one eyed during the wait, the LAL would probably be my only option for my second eye if I decided to go with a second surgery on the fly like you did.
They can adjust it enough to cover changes in the cornea after being out of the contact for a few weeks, but of course that means an additional trip anyway for at least a week and the UV glasses during the wait.
But I will try to adapt and if I can't, I'll make another trip for the other eye, probably switching to a soflens for a while to allow me to see fairly well while the cornea goes to its natural shape and then only have to go about another week lens-less in that eye.
I am encouraged that you still got 20/20 distance in your slightly myopic/astygmatic eye and can use the smartphone with the one eye doing most of the near work. If you had been lucky enough to hit the mark in both eyes do you think you would have gotten as much near as you have now? I kind of get the idea that if one wants to enhance near to insure reading at say 40 CM you probably should ideally be on the mark in one eye with mini mono of -.5 in the near eye.
About how close can you bring your smartphone in before you notice it start to blur? I really am convinced that the Symfony will give a better quality for it's range. If that range gets me to being able to read a smartphone or news print at say 50 cm/about 20 inches in at least one eye and 20/20 distance in at least one eye I think I would be happier than with the trifocal. If I go with the trifocal for the range in one eye and don't think the quality will be there eventually going binocular with trifocals, I may go Symfony in the second eye or bite the two trip travel bullet and go LAL to get back some of what is lost by the light splitting trifocal. I am probably way over thinking it.
They can adjust it enough to cover changes in the cornea after being out of the contact for a few weeks, but of course that means an additional trip anyway for at least a week and the UV glasses during the wait.
But I will try to adapt and if I can't, I'll make another trip for the other eye, probably switching to a soflens for a while to allow me to see fairly well while the cornea goes to its natural shape and then only have to go about another week lens-less in that eye.
I am encouraged that you still got 20/20 distance in your slightly myopic/astygmatic eye and can use the smartphone with the one eye doing most of the near work. If you had been lucky enough to hit the mark in both eyes do you think you would have gotten as much near as you have now? I kind of get the idea that if one wants to enhance near to insure reading at say 40 CM you probably should ideally be on the mark in one eye with mini mono of -.5 in the near eye.
About how close can you bring your smartphone in before you notice it start to blur? I really am convinced that the Symfony will give a better quality for it's range. If that range gets me to being able to read a smartphone or news print at say 50 cm/about 20 inches in at least one eye and 20/20 distance in at least one eye I think I would be happier than with the trifocal. If I go with the trifocal for the range in one eye and don't think the quality will be there eventually going binocular with trifocals, I may go Symfony in the second eye or bite the two trip travel bullet and go LAL to get back some of what is lost by the light splitting trifocal. I am probably way over thinking it.
re: "the Symfony seems forgiving of even if you go a little hyperopic."
It is forgiving in the sense that intermediate&distance are still good, but you can see a noticeable drop in near. My left eye wound up perhaps +0.5D, no astigmatism), though I hadn't tested it with a near eye chart to have a figure for it. I wouldn't be able to use a smartphone with only that eye (other than to just dial the phone). My near vision is mostly from my other eye which is plano (and perhaps -0.5D astigmatism, so perhaps -0.25D spherical equivalent, but I imagine pure plano would be comparable near without the astigmatic distortion). The various laser enhancements seem to be better for myopes than hyperopes, so I'd suggest risking any error being myopic with the Symfony. I gather that with high add multifocals or a trifocal some surgeons prefer risking a hyperopic error since some people find the usual near point too near. There has been some work recently released regarding a new "superformula" (that buzzword is used in the articles) that may do a better job of predicting IOL powers.
If you are considering a trifocal, you might note that Alcon had a new trifocal approved in Europe last summer, the Panoptix, though I don't know if it is available in Canada or Mexico if you don't wish to go that far. I finally found one article that gives some data on it suggesting it might be a slight better bet than the other trifocals:
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/novel-trifocal-iol-extends-range-vision
I hadn't seen other information though to know for sure how it compares to other trifocals. Oddly it is referred to in some places as a modified quadfocal design (the London Eye Hospital seems to be marketing it that way), but since the manufacturer is only billing it as a trifocal that seems more accurate.
I was tempted by a trifocal, since I'd also had good experiences with multifocal contacts. The reason for going with the Symfony was mostly that intermediate vision was more important to me and it seemed a better bet for that, and for better contrast sensitivity. I'd never had complaints about low light vision with multifocal contacts, but it is noticeably better with the Symfony (there is a restaurant I have weekly meetings at with dim light so I notice the difference). I don't know how the multifocal IOLs compare to multifocal contacts however, I'd suspect there is less light loss and that they do better in low light than the contacts. I do gather that as we age we need more light so it could be something I'll appreciate more when I'm older. In addition I guess I figured that even though I'd had good luck with multifocal contacts, there was no harm in avoiding the risk I might have problematic halos with a multifocal IOL despite that.
You mention "probably will be able to by the time the second eye gets a cataract"
I would recommend having a plan ready for the 2nd eye just in case you find it difficult to adjust to an IOL in only one eye. Its usually not a problem, but someone posted here recently for instance about difficulty with aniseikonia issues after having an IOL in only one eye. I felt an imbalance of some sort I didn't diagnose during the hour or so that I had the eye patch off after having one eye done, before I had the 2nd eye done. Its very possible I might have adapted to it quickly if I'd given it a chance, I just decided not to risk it since I'd traveled to Europe to get the surgery and didn't wish to need to make another trip there soon afterward if I couldn't adapt .
It is forgiving in the sense that intermediate&distance are still good, but you can see a noticeable drop in near. My left eye wound up perhaps +0.5D, no astigmatism), though I hadn't tested it with a near eye chart to have a figure for it. I wouldn't be able to use a smartphone with only that eye (other than to just dial the phone). My near vision is mostly from my other eye which is plano (and perhaps -0.5D astigmatism, so perhaps -0.25D spherical equivalent, but I imagine pure plano would be comparable near without the astigmatic distortion). The various laser enhancements seem to be better for myopes than hyperopes, so I'd suggest risking any error being myopic with the Symfony. I gather that with high add multifocals or a trifocal some surgeons prefer risking a hyperopic error since some people find the usual near point too near. There has been some work recently released regarding a new "superformula" (that buzzword is used in the articles) that may do a better job of predicting IOL powers.
If you are considering a trifocal, you might note that Alcon had a new trifocal approved in Europe last summer, the Panoptix, though I don't know if it is available in Canada or Mexico if you don't wish to go that far. I finally found one article that gives some data on it suggesting it might be a slight better bet than the other trifocals:
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/novel-trifocal-iol-extends-range-vision
I hadn't seen other information though to know for sure how it compares to other trifocals. Oddly it is referred to in some places as a modified quadfocal design (the London Eye Hospital seems to be marketing it that way), but since the manufacturer is only billing it as a trifocal that seems more accurate.
I was tempted by a trifocal, since I'd also had good experiences with multifocal contacts. The reason for going with the Symfony was mostly that intermediate vision was more important to me and it seemed a better bet for that, and for better contrast sensitivity. I'd never had complaints about low light vision with multifocal contacts, but it is noticeably better with the Symfony (there is a restaurant I have weekly meetings at with dim light so I notice the difference). I don't know how the multifocal IOLs compare to multifocal contacts however, I'd suspect there is less light loss and that they do better in low light than the contacts. I do gather that as we age we need more light so it could be something I'll appreciate more when I'm older. In addition I guess I figured that even though I'd had good luck with multifocal contacts, there was no harm in avoiding the risk I might have problematic halos with a multifocal IOL despite that.
You mention "probably will be able to by the time the second eye gets a cataract"
I would recommend having a plan ready for the 2nd eye just in case you find it difficult to adjust to an IOL in only one eye. Its usually not a problem, but someone posted here recently for instance about difficulty with aniseikonia issues after having an IOL in only one eye. I felt an imbalance of some sort I didn't diagnose during the hour or so that I had the eye patch off after having one eye done, before I had the 2nd eye done. Its very possible I might have adapted to it quickly if I'd given it a chance, I just decided not to risk it since I'd traveled to Europe to get the surgery and didn't wish to need to make another trip there soon afterward if I couldn't adapt .
I have only seen articles with Drs. Chayet at Codet and Dr. Artal in Spain commenting on small groups of 10 to 15 patients. They seem to agree that a blended micromono approach with high asphericity in the near eye and low asphericity in the distance eye gets a very good binocular result where the near eye is good at 30 and 40 cm and intermediate and still usually gets 20/25 or 20/30 far, and the distance eye 20/20 or better all the way down to 60 cm allowing both eyes to work together most of the time.
I am going to have one eye done with Chayet in March. Leaning toward AT LISA tri and strongly considering Symfony. I don't think the halos or glare at night will be an issue for me with the tri in one eye. I have always experienced them with rgp multifocals, and adjusted. If it is worse than expected I will probably go with the Symfony or LAL in the other eye when it goes south. If I am happy with the tri, I will probably go with it on the second eye. Dr. Chayet is going to recommend which he thinks I will likely be happier with. If I go with the Symfony and come out a little myopic after shooting for plano I would probably go with the LAL in the second to insure a good blended overall system. I am a high myope -8.50 contacts and understand they may miss the target a bit, hopefully not more than the .5 diopter than the Symfony seems forgiving of even if you go a little hyperopic. If I go with the AT LISA and miss the target, I will wear a contact until the other eye goes bad. Hoping for the best.
I would probably go with the LAL if not for the travel requiring two trips, the second one requiring a minimum of the whole week and then the time it takes for the retina to recover from the UV adjustments. If I could do it locally I probably would and probably will be able to by the time the second eye gets a cataract, if it does. My uncle is almost 80, had one eye done a few years ago and still no cataract.
I am going to have one eye done with Chayet in March. Leaning toward AT LISA tri and strongly considering Symfony. I don't think the halos or glare at night will be an issue for me with the tri in one eye. I have always experienced them with rgp multifocals, and adjusted. If it is worse than expected I will probably go with the Symfony or LAL in the other eye when it goes south. If I am happy with the tri, I will probably go with it on the second eye. Dr. Chayet is going to recommend which he thinks I will likely be happier with. If I go with the Symfony and come out a little myopic after shooting for plano I would probably go with the LAL in the second to insure a good blended overall system. I am a high myope -8.50 contacts and understand they may miss the target a bit, hopefully not more than the .5 diopter than the Symfony seems forgiving of even if you go a little hyperopic. If I go with the AT LISA and miss the target, I will wear a contact until the other eye goes bad. Hoping for the best.
I would probably go with the LAL if not for the travel requiring two trips, the second one requiring a minimum of the whole week and then the time it takes for the retina to recover from the UV adjustments. If I could do it locally I probably would and probably will be able to by the time the second eye gets a cataract, if it does. My uncle is almost 80, had one eye done a few years ago and still no cataract.
2 Comments
I had symphony lenses in both eyes several months ago Perfect vision now and no halos
Great. Did you get a mini mono setup or are both eyes refracted the same. Where/who did your procedure. What kind of prescription did you have prior to surgery/
From what I have been able to learn about the LAL it has fewer halos and visual side effects because of the smooth curve changes generated by swelling parts of the lens by shining UV light where you want to increase the power of the lens or add cylinder to correct astigmatism. The side effects are comparable to a monofocal lens. You can get good near vision added at a specific distance, but then lack intermediate correction, or opt for an aspheric correction that will give similiar result to those you get with the Tecnis Symfony, with less risk of missed power target because of the adjustability.
The drawback is the two or three week wait after surgery for adjustments, wearing the uv glasses until adjustments are done, some people suffer a temporary reddish tint to their vision for days or weeks after the adjustments and depending on the adjustments and multifocal or aspheric adjustments being done it could take a week to 10 days for adjustments and power lock in. however the results are very predictable and fine tuned to the visual needs of the individual patient.
The drawback is the two or three week wait after surgery for adjustments, wearing the uv glasses until adjustments are done, some people suffer a temporary reddish tint to their vision for days or weeks after the adjustments and depending on the adjustments and multifocal or aspheric adjustments being done it could take a week to 10 days for adjustments and power lock in. however the results are very predictable and fine tuned to the visual needs of the individual patient.
1 Comments
I recall seeing articles talking about them studying putting multifocal and extended depth of focus patterns on the LAL, however I haven't seen any studies with concrete statistics on the results. I haven't searched in detail in the last year or so since I've already had my surgery, though I keep up with news on the topic out of curiosity. So although I hadn't noticed any news of a new study, its possible I may have missed something. If you have a link to any study results, that would be of interest..
Our surgeons use to fly to Mexico to do LASIK surgery when the FDA was dragging their feet on that.
While the LAL isn't approved here, one of the surgeons who has published about studies on the LAL, Dr. Chayet, offers it in Mexico at Codet Vision.
http://www.codetvision.com/
It is just a mile from the border, near San Diego and they even provides shuttle service from the San Diego Airport and I think from hotels on the US side of the border. I hadn't evaluated the quality of the clinic in detail to confirm its one that I would use, but from the surface it appears to be trying to be a state of the art clinic targeting US medical tourism. Unfortunately the LAL has to be adjusted using their special equipment (and requires you to wear special glasses until that process is finished) so it requires you to be in the area for a few days at least (or to fly back there for adjustment), though after that regular followups could be done in the US. I know they have done work on providing both multifocal patterns as well as extended depth of focus approaches, but I hadn't explored the data and I don't know if they've had many patients use those yet to get a good idea of the results and the level of visual side effects like halos&glare compared to other IOLs.
http://www.codetvision.com/
It is just a mile from the border, near San Diego and they even provides shuttle service from the San Diego Airport and I think from hotels on the US side of the border. I hadn't evaluated the quality of the clinic in detail to confirm its one that I would use, but from the surface it appears to be trying to be a state of the art clinic targeting US medical tourism. Unfortunately the LAL has to be adjusted using their special equipment (and requires you to wear special glasses until that process is finished) so it requires you to be in the area for a few days at least (or to fly back there for adjustment), though after that regular followups could be done in the US. I know they have done work on providing both multifocal patterns as well as extended depth of focus approaches, but I hadn't explored the data and I don't know if they've had many patients use those yet to get a good idea of the results and the level of visual side effects like halos&glare compared to other IOLs.
It is still not FDA approved and given the incompetence and lassitude of the FDA no telling when the light adjustable IOL will be available. One of our physicians has done experimental placement with stellar results. The FDA has reduced physicians, pharmaceutical drug and devices to second rate in my opinion because leading edge care and even main stream world care (example corneal collagen cross-linking for Keratoconus) are not available to us..
JCH MD
JCH MD
The lens can have a central near add added to it or it can be given an aspheric profile which extends depth of focus getting uncorrected results of J2 at 40cm J1 at 60 CM and 20/25 at distance monocularly. They usually maximize the other eye for distance with a lower aspheric profile for good overlap of intermediate vision.
MEDICAL PROFESSIONAL
I would not exchange you IOL. The LAL IOL is not yet approved and it will correct at one distance.
Dr. O.
Dr. O.
I'm afraid I don't know about the LAL but I was fitted with the Zeiss ATLisa trifocal lens 7 weeks ago and I've got excellent near, intermediate and far vision. I'm a computer programmer so I'm using the computer all day. The intermediate vision was the last to sort itself out but it's fine now and getting better all the time.
Have an Answer?
You are reading content posted in the Eye Care Community
Top General Health Answerers
Kansas City, MO
Grand Prairie, TX
San Diego, CA
Discharge often isn't normal, and could mean an infection or an STD.
In this unique and fascinating report from Missouri Medicine, world-renowned expert Dr. Raymond Moody examines what really happens when we almost die.
Think a loved one may be experiencing hearing loss? Here are five warning signs to watch for.
When it comes to your health, timing is everything
We’ve got a crash course on metabolism basics.
Learn what you can do to avoid ski injury and other common winter sports injury.
