Higher Order Aberrations Induced by Light Adjustable Lens Treatment

To determine the magnitude of higher order aberrations (HOAs) induced from light delivery device treatments after implantation of a light adjustable lens (LAL; RxSight).

Patients who underwent cataract surgery or refractive lens exchange with LAL implantation in a private practice were included in this retrospective, consecutive chart review. The iTrace (Tracey Technologies) was used to measure corneal, internal, and total HOAs before each adjustment and lock-in visit at a 3-mm entrance pupil size. HOAs were also measured after the final lock-in visit. Overall and individual HOAs that were induced throughout the course of the LAL treatments were measured. Subgroup analysis was performed analyzing number of adjustments, distance versus near target, spherical aberration induced, target proximity, and history of refractive surgery.

This study included 56 eyes from 32 patients. The mean induction of total HOAs (combined corneal and internal aberrations) was -0.005 μm (standard deviation = 0.071). No induced total HOAs were greater than 0.3 μm. The 32 eyes that had undergone prior refractive surgery were found to have a statistically significant increase in induced HOAs compared to the 24 eyes without prior refractive surgery (P = .02). No other statistically significant differences were detected during subgroup analysis.

This study suggests that LAL treatments do not induce a clinically significant amount of HOAs. However, eyes that have previously undergone refractive surgery may be more likely to have a greater magnitude of HOAs induced by light delivery device treatments.