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The Light Adjustable Lens (LAL) by RxSight is a premium intraocular lens (IOL) implanted during cataract surgery. What makes it unique: after the LAL is in place and your eye has healed, the lens power is fine-tuned using a specialized UV Light Delivery Device. This gives patients and Dr. Geoffrey Collett the ability to refine your final vision based on how your eye actually heals, rather than being locked into a predicted lens power at the time of surgery. FDA-approved in 2017, the LAL is manufactured from a patented photosensitive silicone that responds precisely to controlled UV light exposure.
Cataract surgery with the LAL begins the same way as any modern cataract procedure: phacoemulsification to remove the clouded natural lens, followed by insertion of the folded IOL through a micro-incision. The difference begins at the 2 to 4 week mark, when the eye has healed enough for adjustment.
You return to the office for a Light Delivery Device (LDD) treatment. The LDD shines a controlled pattern of UV light onto the LAL for about 90 seconds, reshaping the lens and shifting its power. Most patients go through three to five LDD treatments over a 4 to 6 week adjustment period. After the final desired vision is achieved, a "lock-in" treatment stabilizes the lens permanently - the LAL is no longer photosensitive after lock-in.
During the adjustment window, UV-protective glasses provided by our office must be worn outdoors and during bright indoor lighting. These glasses prevent ambient UV from changing the lens before you and Dr. Collett have settled on the final prescription.
Traditional IOL selection locks you into a lens power calculated before surgery. If the eye heals differently than predicted or residual astigmatism remains, you may need glasses or a secondary procedure. The LAL flips this: the power is finalized after the eye has fully healed.
The LAL is a strong option for many cataract patients, especially:
The LAL is not a fit for every patient. A candidacy workup at our Bellaire office includes corneal topography, axial length biometry, pupil assessment, and a discussion of your vision priorities. Patients who cannot reliably wear UV-protective glasses during the adjustment window are generally not candidates.
The day-of surgical experience is the same as standard cataract surgery. You arrive at the ambulatory surgery center, the eye is numbed with drops and a local anesthetic, the cataract is removed via phacoemulsification, and the folded LAL is inserted through a small incision. The entire procedure typically takes 15-20 minutes per eye. Both eyes are usually done one to two weeks apart, not the same day.
After both eyes have healed for approximately 17 to 21 days, you return for your first LDD treatment. Dr. Collett refracts your vision, decides on the target power shift, and positions you at the LDD. The UV exposure takes about 60 to 90 seconds per eye. You'll feel nothing unusual during the treatment - no flash, no pain, no pressure. Most patients have three to five treatments spaced 3 to 7 days apart. Between treatments, we allow the lens to stabilize and assess the vision achieved. Once you and Dr. Collett agree the vision is where you want it, a final lock-in treatment stabilizes the lens. The LAL is no longer photosensitive after lock-in.
Between cataract surgery and your final lock-in treatment, the LAL is photosensitive. Ambient UV light - sunlight, some indoor LEDs, tanning beds, arc welding, fluorescent tubes - can change the lens power unpredictably. We provide UV-protective glasses at your surgery visit. You must wear them any time you are outdoors (even on cloudy days) and during bright indoor situations. Indoor normal-lighting activities (reading, watching TV, cooking) do not require the glasses. The UV-protection period typically lasts 4 to 6 weeks from cataract surgery through lock-in.
Medicare and commercial insurance cover the standard portion of cataract surgery. The LAL is a premium IOL and involves an itemized out-of-pocket upgrade that is not covered by insurance (this is standard for any premium IOL including toric and multifocal options). The upgrade fee includes the LAL lens itself plus the series of LDD adjustment treatments and lock-in. CareCredit financing is available to spread the cost over time. Call our office at 281-800-1585 or request an appointment for current LAL pricing.
The LAL protocol involves multiple in-office adjustment visits after the cataract surgery itself. Single-surgeon continuity matters more with LAL than with any other IOL - the person refining your final vision is the same physician who selected the initial power, performed the surgery, and knows your visual goals. Dr. Collett has experience with RxSight's Light Delivery Device and walks patients through each adjustment with an understanding of how each change in power will affect daily vision.
The LAL (RxSight) is a premium intraocular lens implanted during cataract surgery that can be fine-tuned after the eye heals using a Light Delivery Device. It is the only IOL in the US that offers this capability.
Standard IOLs have a fixed power chosen before surgery. The LAL allows power adjustment after surgery, once the eye has healed, so the final prescription can be fine-tuned based on actual healing.
Most patients need three to five LDD treatments followed by a final lock-in treatment, spanning about 4 to 6 weeks after cataract surgery.
Yes. The LDD adjustment can correct for residual astigmatism as part of the post-op fine-tuning process.
You must wear the UV-protective glasses we provide whenever you are outdoors or in very bright indoor lighting. Normal indoor activities (reading, screens, cooking) do not require them.
Insurance covers the standard cataract surgery portion. The LAL premium IOL upgrade is an itemized out-of-pocket expense, same as any premium IOL.
No. After the final lock-in treatment, the LAL is permanently stabilized and is no longer photosensitive.
Call 281-800-1585 or request an appointment online. Learn more about RxSight at rxsight.com.
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