Use of the light-adjustable lens to correct astigmatism after cataract surgery

Abstract
Aim To determine if residual cylindrical refractive error after cataract surgery can be adjusted using the light-adjustable lens (LAL). Methods The LAL is a photosensitive silicone intraocular lens whose power can be adjusted post-operatively using UV light at 365 nm. A digital light delivery device (DLD) is used to adjust LAL power in situ to correct residual refractive errors non-invasively. Profiles developed to correct residual cylindrical and spherical errors were tested on five patients, with postoperative toric refractive errors of 1.25–1.75 D. At 2 weeks post-implantation, best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA) and residual refractive errors were measured. Results Toric error was reduced in each of the patients and refractions remained stable for the 9 month follow-up period. Achieved spherical equivalent manifest refraction (MRSE) was within 0.25 D of targeted emmetropia. All five patients improved their UCVA to ≥20/25 (≤0.1 logarithm of the minimum angle of resolution (LogMAR)) and maintained their BCVA. Conclusion The LAL can be adjusted postoperatively to correct residual astigmatism.