Light Adjustable Lens Experience

[psbpsbpsb]

I had started to discuss my experience with the Light Adjustable Lens in http://www.medhelp.org/posts/Eye-Care/adaptive-IOLs-outside-the-US/show/2076228 but found it was closed today.  I've just had my second adjustment and wanted to give the many interested folks in the community an update on my experience.

I had the second adjustment yesterday afternoon.  As with the first adjustment the appointment began with the optician working with me to look at where I was with my visual acuity and also getting an update on my intraocular pressures.  After being dilated and waiting an hour or so, I went in with the ophthalmologist and had the UV irradiation.  As before, they used topical anesthetic, a contact lens and eyepiece were applied, and the UV light turned on.  This time I didn't find the experience as uncomfortable.  It may be she used less irradiation this time or perhaps I still had part of the lingering washed out vision from the first adjustment still present.  After, I was essentially unable to see out of the treated eye because of a large, intense red/pink distorted area covering most of my visual field.  As the afternoon and evening went on it faded only slightly but I did seem to be able to have more sharpness with some distant objects than before, again, very hard to tell.

This morning still a lot of redness and pink hues especially noticeable when looking at white objects.Green LED lights look white.  But my acuity is returning and I feel that there was definitely an improvement with the second treatment.  The plan is for me to return in a few days for the first lock in and then the second lock in a couple days after that.  It is hard to really know just how well the lens is working at this point as I haven't recovered from the UV irradiation and I'm wearing the dark UV blocking glasses.  But I'm feeling optimistic that my intermediate vision is much better and reading vision also significantly better than my untreated presbyopic eye.  

Unless they close this forum or the moderators delete this post I'll put a couple follow ups on and some observations as I get the lock ins done.


This discussion is related to adaptive IOLs outside the US.

[psbpsbpsb]

Lock in one is finished and lock in two sceduled in the morning.  The lock in was not as uncomfortable as the first adjustment, again perhaps because I knew what to expect.  Same procedure - check refraction and pressures, dilate for an hour, then anesthetic drops and light exposure.  The vision blur and pink fuzzy is quite bad.  The day after I would say my vision is at 20%.  Doctor said the lockins will change the lens about -.25 diopters which is fine as I would like a little bit better near.  She seemed pleased and the lens is adjusted with an aspheric profile to give me a wider range of vision.  She said I will not end up with a strictly monocular focus.  After the final lock in and a bit of time to let my retina recover from the UV irradiation I will report back the final results.  I am so looking forward to ditching these UV glasses.

[flossy93]

Thank you for the latest post.  I think you said before your second lock-in appt would be a few days after the first, so hopefully the UV glasses are only needed for a few more days.

Thanks in advance for your final posting of results, once your second lock-in is over and your vision has recovered.  I'll be very interested to hear about the quality of your vision (halos, blurriness) as well as the clear visual range the LAL gives you with the customized adjustments.  I'm still not totally clear on how it's adjusted for multiple focal lengths (e.g. 'not strictly monocular') but I'll be very interested in your visual experience with the outcome.  

Congratulations in advance for sticking so diligently with the UV-blocking protocol.  Hopefully you will have a great visual outcome and the effort will be well worth the results!

[KayakerNC]

Looked at the other thread, and maybe I missed it, but was there any astigmatism involved in your vision?  Just wondering if it was correctable with the lens or incisions.  If you had any, of course.
So, evidently the LAL is not just an adjustable monofocal.  If the aspheric works out to give you that wider range....super exciting.
Thanks again for the updates.

[John C Hagan III, MD, FACS, FAAO]

There is a good article in Ophthalmology Management March 2014 "The Calhoun adjustable IOL breaks new ground" by Jerry Helzner that might be of interest. Likely is available on their website.

One of our surgeons is using this IOL under an experimental protocol with good results

JCH MD

[KayakerNC]

Thanks for pointing to an excellent article.
http://www.ophthalmologymanagement.com/articleviewer.aspx?articleID=110227
What I find most interesting is; "Though the most promising next-generation IOLs are still in the investigational pipeline, a more varied premium channel is expected to be available in the future."
It would be nice if the FDA process were to surpass the speed of the glaciers.

[John C Hagan III, MD, FACS, FAAO]

The "speed" of FDA approval is literally "killing us"  ''JCH MD