The management of preoperative and residual astigmatism is critical to obtain optimized uncorrected visual acuity. The aim of this study was to determine whether residual astigmatism could be precisely corrected postoperatively using the Light Adjustable Lens (LAL, Calhoun Vision Inc) and to determine the stability of the adjusted refraction.
Ten eyes of 10 patients with cataract and corneal astigmatism between 1.00 and 2.00 diopters (D) were included. After standard phacoemulsification and implantation of the LAL, adjustment and lock-in procedures were completed. Before adjustment and 2 weeks, 6 months, and 1 year after lock-in, a full ophthalmic examination including uncorrected distance acuity (UDVA) and corrected distance visual acuity (CDVA), autorefraction, and manifest refraction was performed.
All surgeries, adjustments, and lock-in procedures were performed with no complications. All eyes achieved ±0.50 D of the targeted cylindrical adjustment. Mean spherical equivalent refraction was 0.03±0.84 D before adjustment and -0.06±0.25 D at final follow-up. The cylinder axis remained the same in 60% of eyes and all eyes were stable within 10° rotation at 12-month follow-up. Seven of 10 eyes achieved UDVA of 20/25 or better whereas all eyes achieved UDVA of 20/32 or better. Corrected distance visual acuity remained stable in all eyes.
In this pilot study, the LAL proved to be an efficient, predictable, and stable method of managing astigmatism in cataract patients.