PURPOSE: To evaluate efficacy, predictability, and stability of refractive treatments using lightadjustable
intraocular lenses (IOLs).
SETTING: University Hospital Virgen de la Arrixaca, Murcia, Spain.
DESIGN: Prospective nonrandomized clinical trial.
METHODS: Eyes with a light-adjustable IOL (LAL) were treated with spatial intensity profiles to
correct refractive errors. The effective changes in refraction in the light-adjustable IOL after
every treatment were estimated by subtracting those in the whole eye and the cornea, which
were measured with a Hartmann-Shack sensor and a corneal topographer, respectively. The
refractive changes in the whole eye and light-adjustable IOL, manifest refraction, and visual
acuity were obtained after every light treatment and at the 3-, 6-, and 12-month follow-ups.
RESULTS: The study enrolled 53 eyes (49 patients). Each tested light spatial pattern (5 spherical; 3
astigmatic) produced a different refractive change (P<.01). The combination of 2 light adjustments
induced a maximum change in spherical power of the light-adjustable IOL of between1.98 diopters
(D) andC2.30 D and in astigmatismof up to2.68 D with axis errors below 9 degrees. Intersubject
variability (standard deviation) ranged between 0.10 D and 0.40 D. The 2 required lock-in procedures
induced a small myopic shift (range C0.01 to C0.57 D) that depended on previous adjustments.
CONCLUSIONS: Light-adjustable IOL implantation achieved accurate refractive outcomes (around
emmetropia) with good uncorrected distance visual acuity, which remained stable over time.
Further refinements in nomograms and in the treatment’s protocol would improve the predictability
of refractive and visual outcomes with these IOLs.