Abstract
The purpose of this manuscript is to review the design, development and clinical results of the light adjustable lens (LAL). Evolution in techniques, biometry and intraocular lens (IOL) calculation have improved outcomes and increased expectations after cataract surgery. Nevertheless, Imprecise IOL power determinations, pre-existing and surgical-induced astigmatism, and previous corneal refractive surgery continue to limit post-operative uncorrected vision. The LAL was designed to provide a stable, precise correction of refractive errors with a safe, non-invasive post-operative procedure. The concept behind the LAL is based on photochemistry and diffusion. The adjustment occurs when all non-attached solutes equally distribute themselves throughout the optic after irradiation with ultraviolet light that causes the photosensitive macromers to polymerise in the irradiated region. Clinical results have been positive, with the largest series (122 eyes) showing 97 % of patients within 0.25 D of attempted spherical equivalent and 100 % uncorrected vision 20/25 or better. In conclusion, the LAL has demonstrated to be a safe, accurate and reliable method of post-operative, non-surgical correction of residual sphero-cylindrical refractive error.
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