Fine-tuning vision after cataract surgery with light-adjustable intraocular lenses
June 26, 2025
Until recently, patients who had cataract surgery to replace a cloudy natural lens in their eye had limited options to adjust their vision if it was less than optimal following surgery. Once the artificial lens was placed, there was no way to adjust the focus of vision except through the use of glasses, contact lens, or additional laser surgery such as LASIK.
Fortunately, we’ve come a long way in cataract surgery, most recently by the development of a light-adjustable lens (LAL) that can be optimized for vision after surgery. LALs offer the unique ability to fine-tune the power of the intraocular lens after cataract surgery. This improves the likelihood of achieving perfect or near-perfect vision without the need for glasses or additional eye surgery.
The latest upgrade in LAL technology is called LAL+, which extends the depth of the focus of the lens, offering a greater range of vision. LAL+ technology allows patients to see better right after surgery with the same adjustability if they need it. LAL+ technology gives people with cataracts a new option for regaining the best vision possible – and it may even benefit some people for whom traditional lens implants may not work as well.
With the number of people with cataracts in the U.S. expected to double from 24.4 million in 2010 to 50 million by 2050, LAL and LAL+ technologies are giving more people with cataracts customized control in their quest to regain clearer vision.
How do light-adjustable lens implants work?
The surgical procedure for removing your cataract and implanting a light-adjustable lens is the same as that used in traditional cataract surgery. If you need cataracts removed from both eyes, we’ll do the procedure on one eye and then do the other eye a few weeks later.
What’s different about light-adjustable lenses comes after surgery.
About three weeks after your surgery, we will test your vision. Based on that exam, we will start fine-tuning your vision by making quick, painless adjustments to your lens – each session taking about two minutes or less.
Cataracts are a normal part of aging and can develop in one or both eyes. They occur when the normally clear lens of the eye becomes cloudy and alters vision.
LAL+ implants are made of a special photosensitive material that can be altered by exposure to ultraviolet (UV) light. You will sit in front of a light delivery device that non-invasively delivers UV light to your LAL+. The UV light makes the lens change shape and alters how well it focuses light. We can shine the light to adjust different parts of the lens in each eye, making each lens more or less curved depending on what you need to see better.
Then you’ll go home and test out your new vision. If you find it still needs to be tweaked, you can return for additional adjustments. These usually will be performed in weekly intervals. It’s possible to make up to three adjustments, although you may only need one or two.
When you’re happy with your vision, we’ll perform two final “lock-in” light treatments, after which the LAL+ implant can no longer be changed. The adjustment period can take four to six weeks, but there’s no rush or deadline. The nice thing about LAL+ is that you have the freedom to test your vision and decide what works for you.
If you have had a prior eye surgery, such as LASIK or its predecessor, radial keratotomy (RK), your eyes may need a little more time after the cataract surgery to heal before starting LAL+ adjustments, and that’s fine. I’ve had patients who waited six months before we started adjusting their lenses.
If you choose to get LAL+ implants, you’ll need to wear UV-protective glasses during all waking hours starting immediately after surgery until the last lock-in treatment is completed. This is to prevent your new lenses from undergoing unintended changes when exposed to UV rays, such as sunlight.
Related: How cataract surgical advancements improve recovery
Is a light-adjustable lens implant right for you?
The choice between LAL+ implants and traditional lens implants will come down to your unique eye anatomy, eye health and history, and preferences.
LAL+ can be a great option if you have had prior eye procedures, such as LASIK or RK. LAL+ often works well for people with complex refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism (an irregularly shaped cornea), or presbyopia (age-related farsightedness).
LAL+ may not be the best choice if:
- Your eyes do not dilate well or you have small pupils. We need to dilate your eyes to adjust the lens after surgery. If we can’t get your pupils big enough, we won’t be able to use the light therapy.
- You cannot attend multiple post-operative visits. Fine-tuning the LAL+ implants may require multiple UV light therapy sessions.
- You would prefer not to wear dark glasses for weeks. LAL+ lenses change shape with UV light. You will need to wear UV-protective glasses after surgery to avoid unintended lens changes before the lens shape is locked in.
Other intraocular lens options
If light-adjustable lenses aren’t a good fit for you, other intraocular lens options may work just as well or better. These may include:
- Monofocal: This lens has one focusing distance, providing only near, medium, or distance vision.
- Trifocal or multifocal: These lenses have multiple focusing distances in different areas of the lens that can bring into focus objects at a far, medium, or close distance from the patient’s eye.
- Extended depth of focus / range of vision: These lenses can give patients far, medium, and some near-distance vision. People who have had LASIK or another eye surgery may find that these lenses reduce the need for wearing glasses or seeing halos of light at night.
- Toric: This lens has different focusing powers in different areas of the lens to correct astigmatism. Most types of lenses come in toric versions.
Unlike LAL+, these intraocular lens implants have a fixed prescription built into them. We use advanced technology to design a lens for your unique anatomy and vision needs.
Before surgery, our ophthalmologists measure the affected eye with light waves that map its surface using Swept Source noninvasive optical coherence tomography (OCT). We then run the OCT data through complex formulas that use the measurements of the eye’s anatomy and curvature to predict the ideal lens.
At the same time, we can customize your replacement lenses based on your needs, meaning we can correct or improve nearsightedness, farsightedness, or astigmatism.
Related reading: AI and virtual reality: The future of cataract surgery has arrived
You have options with cataract surgery
If the thought of cataract surgery makes you nervous, it’s completely normal. Be assured that you won’t be alone in the decision-making. At UT Southwestern Medical Center, my highly skilled ophthalmology colleagues and I have extensive experience in treating people with cataracts and have access to the latest scientific findings and treatments for cataracts.
Based on extensive testing and your goals for the surgery, we will walk you through your options for intraocular lens implants and answer all your questions. Together, we will find the best lens customized specifically for your eyes and your lifestyle.
To talk with an ophthalmologist, make an appointment by calling 214-645-2027 or request an appointment online.
