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

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.