Published in Cataract

The Ultimate Guide to the RxSight Light Adjustable Lens®

This post is sponsored by RxSight

Discover the RxSight Light Adjustable Lens® and gain key insights from cataract and refractive experts.

The Ultimate Guide to the RxSight Light Adjustable Lens®
Cataract surgery is one of the most common surgical procedures performed in the United States.1 In a world of advancing technology and longer life expectancy,2 modern cataract surgery is no longer limited to vision restoration but instead may have a marked impact on maintaining and improving vision-related quality of life.3 Patients now expect high-quality vision that matches their dynamic lifestyles and unique needs.3 As a result, the intraocular lens (IOL) market has seen an emergence in lens replacement options attempting to meet the increasing demands and expectations of patients undergoing cataract surgery.4
Historically, traditional cataract surgery has relied upon the use of fixed-power IOLs. However, it is estimated that only 70-75% of cataract surgeries utilizing fixed-power IOLs achieve their post-refractive target,5 which can create gaps in patient expectations regarding their visual goals. Additionally, achieving predicted post-op targets does not necessarily guarantee patient satisfaction. The development of the Light Adjustable Lens™ (LAL®/LAL+™) has begun to disrupt the classic treatment paradigm by allowing the power of the IOL to be titrated approximately two to four weeks after surgery. Not only does this permit modifications to the IOL that may not have been accounted for during preoperative testing but the IOL can also be customized for each patient’s lifestyle and unique visual needs in real time, post surgically.
Created by RxSight, the Light Adjustable Lens is the first and only (at the time of publication of this article) FDA-approved IOL whose refractive power can be adjusted postsurgically – giving both doctors and patients more control in visual optimization.

What are the limitations of traditional “fixed” intraocular lenses?

A successful IOL implantation that can achieve the intended refractive result in the eyes of both surgeon and the patient relies in part on careful preoperative planning. This workflow might be impacted by confounding factors that can be difficult to control, including common sources of error when performing biometry like IOL position, axial length, and corneal power, in which small discrepancies can have a major impact on final results.6 The presence of higher order aberrations, the patient's astigmatic profile, and the status of the ocular surface and tear film can also play a major role in postoperative outcomes,7,8 adding another layer of complexity to postsurgical visual outcomes, including the corneal healing process and postoperative lens positioning. These factors can ultimately lead to refractive surprise postoperatively, which may warrant the need for additional procedures such as refractive corneal surgery (i.e. LASIK or LRI), or less favorable, an IOL exchange.

What makes the RxSight Light Adjustable Lens different?

RxSight has changed the game in the cataract surgery arena with the Light Adjustable Lens.9 As a result of proprietary photosensitive material that can be reshaped in response to ultraviolet (UV) light, the Light Adjustable Lens can be adjusted postoperatively up to three times in approximately two to four weeks to improve uncorrected visual acuity. Not only does this allow for lens power modifications that may provide a solution in cases of refractive surprise, but it may also help to reduce the impact of variability in the preoperative decision-making process. The adjustability of this lens allows for patients to test drive their postoperative visual outcome in their daily lives and provide feedback to the surgeon and co-managing doctors for modification prior to finalizing postsurgical vision. Subsequently, this empowers the patient to be more vested with a level of control in their visual outcome.

How exactly does the Light Adjustable Lens work?

The Light Adjustable Lens is a silicone, three-piece IOL (two haptics to hold the lens in place) that contains photosensitive macromers distributed throughout the lens. When a wavelength of 365 nm of ultraviolet (UV) light is applied from an instrument called the Light Delivery Device (LDD) directly to a specific area of the lens, the macromers in the path of the light polymerize to neighboring macromers. The remaining unpolymerized macromers then diffuse into the light-exposed area. This movement can create a highly predictable change in the curvature of the lens that effectively revises the spherical and sphero-cylindrical power of the lens.
It should be noted that the LDD delivers light treatment as opposed to laser treatment. While the LDD delivers light of a single wavelength as would a laser, this light treatment delivers incoherent light while a laser delivers coherent light.
The Light Adjustable Lens is available in powers of +4 D to +30 D, with availability from +16 D to+24 D in 0.50 D increments to match the patient’s refractive target as closely as possible. From there, the LDD can manage up to 2 diopters of myopic or hyperopic spherical refractive error and up to 2 diopters of astigmatism.
Residual astigmatism (> 0.75 D) is one of the most common sources of patient dissatisfaction postoperatively.10 Of note, the Light Adjustable Lens can correct as low as 0.50 diopters of astigmatism. The ability to treat 0.50 diopters of postoperative cylinder makes this IOL the only technology in the United States approved to correct this level of astigmatism.11 From a clinical perspective, leveraging this capability could enhance postoperative visual satisfaction along with dynamic, functional visual acuity and low-contrast acuity.11

Who is a candidate for Light Adjustable Lens?

Nick Bruns, OD, FAAO, has been practicing in the refractive surgery space for his entire career, has experienced his patients receiving enhanced visual outcomes with a Light Adjustable Lens. He would pose the question, “Who isn’t a good candidate for an RxSight Light Adjustable Lens?” Dr. Bruns has found that the overall proportion of patients in his practice could benefit from Light Adjustable Lens—far outnumbering those who might not be appropriate candidates for the lens.
Ron Carr, OD, FAAO, an optometrist with over 30 years of practice in a co-management setting, has also observed tremendous patient satisfaction when electing to proceed with a Light Adjustable Lens. He finds it meets the visual needs of many of his patients through its adjustability in the weeks following cataract surgery. Dr. Carr believes that the capability to customize the lens power postoperatively makes it a viable treatment option for a wide array of patient types. He also emphasizes the importance of patient education and setting realistic expectations—especially when it pertains to a patient’s preoperative visual demands and lifestyle goals.

A look at the Light Adjustable Lens workflow—the journey and considerations

As with any cataract surgery, the preoperative workflow begins with patient education and setting appropriate expectations. A simplified scripted explanation for patients about the Light Adjustable Lens process during the initial cataract evaluation is an imperative step to set them up for potential success. While the patient ultimately has decision-making authority, they still need to explicitly understand both the time commitment and the critical importance of strict adherence to the protocol from the Day 1 postoperative visit to the final lock-in treatment.
It is important to stress compliance with UV-protective lens wear early and often throughout the entire surgical journey, as non-compliance may affect a patient’s refractive outcomes if the macromers of the lens are altered by other ultraviolet light sources, such as the sun. The Light Adjustable Lens does incorporate redundant UV protection within the anterior portion of the lens called ActivShieldTM that provides an extra layer of protection against UV light. Subsequently, this feature of the Light Adjustable Lens aids to lessen the potential concern for accidental sunlight exposure in the patient’s everyday environment.12
It is imperative that patients comply with required follow-up visits. The Light Adjustable Lens process consists of both LDD adjustment and lock-in treatments. Of note, the patient will undergo at least one adjustment treatment at 2-3 weeks and can have up to 3 per eye, with 2 lock-in treatments per eye to reach an appropriate visual endpoint based on the patient’s goals and lifestyle.
It is critical to communicate these steps to patients throughout the cataract surgery journey as they may have pre-existing expectations regarding the postoperative follow-up schedule from friends or family members who elected to pursue standard cataract surgery. As an added benefit, these visits provide additional touchpoints with patients to champion their selection of the Light Adjustable Lens while reminding them of their lifestyle and overarching visual goals. In totality, this serves to strengthen rapport with patients.
“I’ve been pleasantly surprised with how patients actually look forward to the chair time between surgery and our final light treatment,” says Dr. Bruns. “The time between each light adjustment gives the patient a really exciting opportunity to live their life, see where we’ve met the mark, and then take ownership over their own improvements. Overwhelmingly, our patients enjoy the adjustment period and it’s not at all a deterrent.”
Dr. Bruns also adds that the period of intimately working with patients enables him to strengthen the doctor-patient relationship, a critical element for successful incorporation of unique technology and practice growth.

Taking a closer look: Light Adjustable Lens implantation to adjustment

The surgical implantation of the Light Adjustable Lens following cataract extraction follows the standard procedures of most three-piece IOLs, although a specific and proprietary IOL insertion device is used during surgery for the RxSight Light Adjustable Lens.
Each office’s exact postoperative schedule may vary, though the postoperative drop schedule is similar to standard or other premium cataract surgeries. A one-day postoperative visit is common, and a one-week visit can be performed by the comanaging eyecare provider (ECP). At the first postoperative visit at which an adjustment could potentially be performed, a technician or ECP would ask guided intake questions, obtain another objective refractive measurement, and take the patient’s visual acuity at all ranges.
Afterward, refraction would be performed coupled with a supportive discussion with the patient about their visual goals and to reiterate realistic expectations. The next step would be to demonstrate any potential adjustment options with trial lenses, along with patient input to assist with the ECP’s decision-making for the LDD treatment. This is a great moment to model what the patient’s vision might look like ahead of the lock-in visits.
The doctor will then perform a slit lamp exam to assess the level of anterior chamber inflammation present and whether ocular surface dryness might warrant waiting until a subsequent visit to perform a light adjustment. If the ECP has determined the healing process to be stable and that a LDD adjustment can be performed, the patient would be dilated to fully visualize the Light Adjustable Lens haptics and optic.
The first light adjustment of the IOL, however, is not performed until at least 17 days have passed to allow enough time for proper healing, in accordance with original FDA studies13. Subsequently at the 17–21-day mark after surgery, patients can return for examination and their first adjustment treatment. The second and third adjustment treatments, if necessary, are all separated by about 3-5 days.
Patients generally receive their first lock-in treatment at 3-5 days after the final adjustment treatment. The second lock-in treatment may be performed 3-5 days thereafter. Depending on the adjustment(s) performed, all eyes can receive one to three adjustments and one or two lock-in treatments.
Note: The additional postoperative commitment required for patients choosing the Light Adjustable Lens can impact the surgeon’s typical scheduling patterns.12
Dr. Bruns chooses to take the adjustment period one step at a time:
“We do the first treatment after day 17 if the patient is healed,” he says. “I use the analogy of a golf course, where you start with the ball on the fringe and aim for that first hole. We may get lucky and hit it right away, but it’s ok if we need to let that ball come to rest and realign because we know we are going to get there.”

Light Adjustable Lens workflow snapshot:

Dr. Bruns supports the idea of letting a patient “live” in a lens, whether this means postponing an adjustment for a vacation or just to go play golf and learn more about what they would like to improve.
“The post-op period is really exciting,” adds Dr. Carr. “Patients are seeing improvements in their vision and it’s all leading up to the lock-in.”
The lock-in process is initiated after three adjustments have been performed, or sometimes after only one or two if the patient is pleased with their vision. The process consists of two separate visits, though a final refraction is required at the first lock-in visit, prior to dilation. A lock-in treatment is similar to an adjustment, except that the refractive power is not changed, and the light is delivered over the entire lens. During the lock-in, the molecules in the IOL become “frozen,” and are no longer able to be adjusted.
The lock-in light is delivered for 90 seconds during the first lock-in treatment, and 120 seconds for the second lock-in treatment. The patient should be made aware that their eyes may feel more dry than usual following the lock-in treatment, which is why Dr. Bruns recommends the use of lubricating drops during this time.
The patient should continue to wear their UV protective lenses until 24 hours after their second and final lock-in treatment.

Does the UV light administered during LDD treatments pose any safety issues?

The high safety profile for both the Light Adjustable Lens and the LDD has been extensively documented through long-term results of multiple studies.14 A trial evaluating the potential negative effects of UV irradiation exposed to the macula found that the UV light administered to the Light Adjustable Lens during the LDD adjustment treatments did not affect the development of postoperative cystoid macular edema (CME) and had no effect on the layers of the macula.15 Additionally, there were no signs evident of retinal toxicity after a study was conducted to evaluate this type of potential tissue damage using up to 5 times the maximum dosage of UV light used during LDD treatments.16 Further, it was found that the UV light exposure for LDD treatments did not add to corneal endothelial cell loss caused by cataract surgery itself.15, 17

Why choose adjustability?

The ability to customize the Light Adjustable Lens after cataract surgery gives the patient the opportunity to influence their postoperative vision. When asked his thoughts on the Light Adjustable Lens compared to other premium IOLs, Dr. Carr shared that “there has not been in my experience a better quality of vision postoperatively.” Additionally, Dr. Bruns added that “there's always a “but” with a multifocal lens or an EDOF lens. Rarely do we get anybody who's unhappy as long as we've set the expectation to be realistic, too.”

Postoperative considerations: Impact of dry eye disease on the Light Adjustable Lens process?

Similarly to how dry eye disease (DED) can significantly impact preoperative biometry measurements for cataract surgery, it can also impact the accuracy of the postoperative refractions and delay the Light Adjustable Lens postoperative treatment timeline.
It is known that intraocular surgery can induce the symptoms of DED19 and it is considered an underestimated problem for patients undergoing cataract surgery.1 A reduction in tear film quality can directly impact vision quality after cataract surgery and create delays in assessing refractive targets during the postoperative period. With this said, it is highly recommended to take a proactive approach to identify DED and initiate ocular surface treatment for patients at the preoperative planning stage prior to cataract surgery in order to optimize biometric results. This includes assessing for blepharitis, meibomian gland dysfunction and neurotrophic keratitis (NK), since all of these conditions can be instigators and/or comorbidities of DED. In the off chance that symptoms only arise in the postoperative period, it would be advised to follow a similar treatment protocol noted preoperatively to decrease the inflammatory response.
Referring the patient back to their optometrist for ocular surface management between Light Adjustable Lens treatments is a refined approach and a great way to illustrate the collaborative OD/MD relationship. It’s mutually beneficial—as the Light Adjustable Lens patient can be confident that they are under the care of an ophthalmic team who has the pulse on their visual needs from start to finish.

The optometrist’s role with the Light Adjustable Lens

The chair time and attention needed for each Light Adjustable Lens patient often requires a collaborative approach between the co-managing optometrist and surgeon to provide a seamless patient cataract surgery journey and enhanced experience. An accurate refraction at each postoperative visit is crucial, and optometrists are not only well versed to provide these, but oftentimes have access to refractive data and historical knowledge of the patient’s lifestyle which may help shape the discussion surrounding how best to map out the adjustment visits and respective visual expectations.
Dr. Carr believes that too often, optometrists think they don’t need to be involved with cataract IOL technologies, since surgeons have traditionally been the decision-makers. “I would really encourage optometrists who are new to this technology to become thoroughly educated by attending meetings, reading articles, meeting with the surgeons, and understanding the process that's involved,” he explains. “The surgeon often relies heavily on the refraction that's provided to them by the optometrist. So, I think this is absolutely an arena in which optometrists can and should be involved.”
As Dr. Bruns says, “if you're not offering this to your patients you're going to lose patients — because they’re going to go to another practice that offers it. We may have patients coming to see us who found us on the internet. If that happens to be your patient and you're not co-managing these types of patients, that will potentially affect your practice. So, my advice to optometrists is to really get involved and know the technology. We're critical players with this technology and we should be well educated about it.”

What’s new for RxSight and the Light Adjustable IOL?

There are over 732 practices with 1,300+ surgeons and 400+ optometrists who have embraced the Light Adjustable IOL in their practices.
In early 2024, RxSight introduced the LAL+ which has been optically designed to slightly extend the depth of focus of the lens compared to their previous model. They have also updated the form factor of the LDD, coming in a more compact size to better serve surgeons with limited office space.
“This technology is here to stay, and if you're not getting in now, you're going to be behind," says Dr. Bruns. "So if you consider yourself somebody who is technologically driven and on the forefront of eye care, this is it."

Final takeaways

The Light Adjustable Lens is the first and only intraocular lens that can be customized after cataract surgery, uniquely giving the surgeon, the optometrist, and the patient a shared partnership in defining and enhancing the visual outcome.
By embracing your role in Light Adjustable Lens adoption, you might begin to think differently about the cataract surgery discussion. By shifting the narrative towards a customizable visual experience, it can empower patients to be more vested in the process, along with appreciating the ECP’s skill set to help meet the moment to match their lifestyles goals to the final outcome.
Acknowledgments This article was peer-reviewed by Michael S. Cooper, OD, President, Visionary Medical Education, LLC. 

INDICATIONS FOR USE AND IMPORTANT SAFETY INFORMATION

INDICATIONS: The Light Adjustable Lens® (LAL®) and Light Delivery Device™ (LDD™) system is indicated for the reduction of residual astigmatism to improve uncorrected visual acuity after removal of the cataractous natural lens by phacoemulsification and implantation of the intraocular lens in the capsular bag in adult patients with preexisting corneal astigmatism of ≥ 0.75 diopters and without preexisting macular disease. The system also reduces the likelihood of clinically significant residual spherical refractive errors.

CONTRAINDICATIONS: The Light Adjustable Lens is contraindicated in patients who are taking systemic medication that may increase sensitivity to ultraviolet (UV) light as the LDD treatment may lead to irreversible phototoxic damage to the eye; patients who are taking a systemic medication that is considered toxic to the retina (e.g., tamoxifen) as they may be at increased risk of retinal damage during LDD treatment; patients with a history of ocular herpes simplex virus due to the potential for reactivation from exposure to UV light; patients with nystagmus as they may not be able to maintain steady fixation during LDD treatment; and patients who are unwilling to comply with the postoperative regimen for adjustment and lock-in treatments and wearing of UV protective eyewear.

WARNINGS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting an IOL in a patient with any of the conditions described in the Light Adjustable Lens and LDD Professional Use Information document. Caution should be used in patients with eyes unable to dilate to a pupil diameter of ≥ 7 mm to ensure that the edge of the Light Adjustable Lens can be visualized during LDD light treatments; patients who the doctor believes will be unable to maintain steady fixation that is necessary for centration of the LDD light treatment; patients with sufficiently dense cataracts that preclude examination of the macula as patients with preexisting macular disease may be at increased risk for macular disease progression; and patients at high risk for future vitreoretinal disease that may require silicone oil as part of therapy. The Light Adjustable Lens must be implanted in the correct orientation with the back layer facing posteriorly.

PRECAUTIONS: The long-term effect on vision due to exposure to UV light that causes erythropsia (after LDD treatment) has not been determined. The implanted Light Adjustable Lens MUST undergo a minimum of 2 LDD treatments (1 adjustment procedure plus 1 lock-in treatment) beginning at least 17-21 days post-implantation. All clinical study outcomes were obtained using LDD power adjustments targeted to emmetropia post LDD treatments. The safety and performance of targeting to myopic or hyperopic outcomes have not been evaluated. The safety and effectiveness of the Light Adjustable Lens and LDD have not been substantiated in patients with preexisting ocular conditions and intraoperative complications. Patients must be instructed to wear the RxSight-specified UV protective eyewear during all waking hours after Light Adjustable Lens implantation until 24 hours post final lock-in treatment. Unprotected exposure to UV light during this period can result in unpredictable changes to the Light Adjustable Lens, causing aberrated optics and blurred vision, which might necessitate explantation of the Light Adjustable Lens.

ADVERSE EVENTS: The most common adverse events (AEs) reported in the randomized pivotal trial included cystoid macular edema (3 eyes, 0.7%), hypopyon (1 eye, 0.2%), and endophthalmitis (1 eye, 0.2%). The rates of AEs did not exceed the rates in the ISO historical control except for the category of secondary surgical interventions (SSI); 1.7% of eyes (7/410) in the Light Adjustable Lens group had an SSI (p < .05). AEs related to the UV light from the LDD include phototoxic retinal damage causing temporary loss of best spectacle corrected visual acuity (1 eye, 0.2%), persistent induced tritan color vision anomaly (2 eyes, 0.5%), persistent induced erythropsia (1 eye, 0.3%), reactivation of ocular herpes simplex Infection (1 eye, 0.3%), and persistent unanticipated significant increase in manifest refraction error (≥ 1.0 D cylinder or MRSE) (5 eyes, 1.3%). CAUTION: Federal law restricts this device to sale by or on the order of a physician. Please see the Professional Use Information document for a complete list of contraindications, warnings, precautions, and adverse events.

INDICATIONS: The Light Adjustable Lens+™ (LAL+™) and Light Delivery Device™ (LDD™) system is indicated for the reduction of residual astigmatism to improve uncorrected visual acuity after removal of the cataractous natural lens by phacoemulsification and primary implantation of the intraocular lens in the capsular bag in adult patients with preexisting corneal astigmatism of ≥ 0.75 diopters and without preexisting macular disease. The system also reduces the likelihood of clinically significant residual spherical refractive errors.

CONTRAINDICATIONS: The LAL+ is contraindicated in patients who are taking systemic medication that may increase sensitivity to ultraviolet (UV) light as the LDD treatment may lead to irreversible phototoxic damage to the eye; patients who are taking a systemic medication that is considered toxic to the retina (e.g., tamoxifen) as they may be at increased risk of retinal damage during LDD treatment; patients with a history of ocular herpes simplex virus due to the potential for reactivation from exposure to UV light; patients with nystagmus as they may not be able to maintain steady fixation during LDD treatment; and patients who are unwilling to comply with the postoperative regimen for adjustment and lock-in treatments and wearing of UV protective eyewear.

WARNINGS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting an IOL in a patient with any of the conditions described in the LAL+ and LDD Professional Use Information document. Caution should be used in patients with eyes unable to dilate to a pupil diameter of ≥ 7 mm to ensure that the edge of the LAL+ can be visualized during LDD light treatments; patients who the doctor believes will be unable to maintain steady fixation that is necessary for centration of the LDD light treatment; patients with sufficiently dense cataracts that preclude examination of the macula as patients with preexisting macular disease may be at increased risk for macular disease progression; and patients at high risk for future vitreoretinal disease that may require silicone oil as part of therapy. The LAL+ must be implanted in the correct orientation with the back layer facing posteriorly.

PRECAUTIONS: The safety and effectiveness of the LAL+ has not been substantiated in clinical trials. The effects of the LAL+ optical design on the quality of vision, contrast sensitivity, and subjective visual disturbances (glare, halo, etc.) have not been evaluated clinically. Surgeons must weigh the potential benefits of the modified optical design of the LAL+ against the potential for risks associated with degradation in vision quality and the lack of clinical data to characterize the impact of the LAL+ optical design on contrast sensitivity and subjective visual disturbance. These considerations may be especially relevant to patients with certain pre-existing ocular conditions (prior corneal refractive surgery, irregular corneal astigmatism, severe corneal dystrophy, macular disease, or optic nerve atrophy, etc.) or intraoperative conditions (posterior capsular rupture, complications in which the IOL stability could be compromised, inability to place IOL in capsular bag, etc.). The long-term effect on vision due to exposure to UV light that causes erythropsia (after LDD treatment) has not been determined. The implanted LAL+ MUST undergo a minimum of 2 LDD treatments (1 adjustment procedure plus 1 lock-in treatment) beginning at least 17-21 days post-implantation. All clinical study outcomes were obtained using LDD power adjustments targeted to emmetropia post-LDD treatments. The safety and performance of targeting to myopic or hyperopic outcomes have not been evaluated. The safety and effectiveness of the LAL+ and LDD have not been substantiated in patients with preexisting ocular conditions and intraoperative complications. Patients must be instructed to wear the RxSight-specified UV protective eyewear during all waking hours after LAL+ implantation until 24 hours post final lock-in treatment. Unprotected exposure to UV light during this period can result in unpredictable changes to the LAL+, causing aberrated optics and blurred vision, which might necessitate explantation of the LAL+. When performing refraction in patients implanted with the LAL+, confirmation of refraction with maximum plus manifest refraction technique is recommended.

ADVERSE EVENTS: The most common adverse events (AEs) reported in the randomized pivotal trial of the parent LAL included cystoid macular edema (3 eyes, 0.7%), hypopyon (1 eye, 0.2%), and endophthalmitis (1 eye, 0.2%). The rates of AEs did not exceed the rates in the ISO historical control except for the category of secondary surgical interventions (SSI); 1.7% of eyes (7/410) in the LAL group had an SSI (p < .05). AEs related to the UV light from the LDD include phototoxic retinal damage causing temporary loss of best spectacle corrected visual acuity (1 eye, 0.2%), persistent induced tritan color vision anomaly (2 eyes, 0.5%), persistent induced erythropsia (1 eye, 0.3%), reactivation of ocular herpes simplex Infection (1 eye, 0.3%), and persistent unanticipated significant increase in manifest refraction error (≥ 1.0 D cylinder or MRSE) (5 eyes, 1.3%).

CAUTION: Federal law restricts this device to sale by or on the order of a physician. Please see the Professional Use Information document for a complete list of contraindications, warnings, precautions, and adverse events

©2024 RxSIGHT. All Rights Reserved. COM-1182 Rev. A

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For clinical study data, please see the FDA Summary of Safety and Effectiveness.


1.  Biela K, Winiarczyk M, Borowicz D, Mackiewicz J. Dry Eye disease as a cause of refractive errors after cataract surgery – A systematic review. Clinical Ophthalmology. 2023;Volume 17:1629-1638.
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3.Lamoureux EL, Fenwick E, Pesudovs K, Tan D. The impact of cataract surgery on quality of life. Curr Opin Ophthalmol. 2011 Jan;22(1):19-27.
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8. Epitropoulos AT, Matossian C, Berdy GJ, et al. Effect of tear osmolarity on repeatability of keratometry for cataract surgery planning. J Cataract Refract Surg 2015; 41:1672–1677.
9. RxSight P160055: FDA Summary of Safety and Effectiveness Data. 2017.
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Lily Arendt, OD, FAAO
About Lily Arendt, OD, FAAO

Lily Arendt, OD, FAAO, is an optometrist at Parkhurst NuVision. Her areas of interest include the treatment and management of anterior segment disease and helping patients achieve their best, natural vision through refractive procedures such as LASIK, EVO ICL, and laser cataract surgery. She is passionate about educating current students and colleagues through writing and speaking engagements in her community. Dr. Arendt is the president of Bexar County District Optometric Society and an active member of the Texas Optometric Association to help advance medical optometry.

Lily Arendt, OD, FAAO
Margaret Moore, OD, FAAO
About Margaret Moore, OD, FAAO

Dr. Moore practices in an ophthalmology-optometry practice near New Haven, Connecticut. She holds a bachelor of science degree from the University of Notre Dame and a doctorate in optometry from The Ohio State University College of Optometry. While in optometry school, she was a member of the Beta Sigma Kappa Honor Society and served both as President of the National Optometric Student Association and as a board member for Students Volunteer Optometric Services to Humanity (SVOSH), with whom she traveled to Guatemala to perform eye exams.

After optometry school, she completed a residency in ocular disease and low vision rehabilitation at the West Haven Veterans Affairs Hospital, where she worked closely with various ophthalmology specialists from Yale School of Medicine and managed low vision patients in the inpatient Eastern Blind Rehabilitation Center. She obtained her Fellowship in the American Academy of Optometry in 2019.

In practice, Dr. Moore focuses on comprehensive and medical eyecare with focuses on urgent eyecare, glaucoma, ocular surface disease and post-surgical cataract/glaucoma care. She also maintains a strong interest in low vision solutions for visual impairment. She is a member of the American Optometric Association, Connecticut Association of Optometrists, and National Glaucoma Society.

Margaret Moore, OD, FAAO
Nicholas Bruns, OD, FAAO
About Nicholas Bruns, OD, FAAO

Nicholas Bruns, OD, FAAO, graduated with high academic honors from the Michigan College of Optometry. During his academic years, his clinical work focused on surgical management of ocular disease, primary care, and contact lenses. He completed his undergraduate work at Central Michigan University and graduated cum laude with a degree in biomedical science.

Dr. Bruns also has extensive experience with cataracts, glaucoma, and laser vision correction. He currently works at Summit Eye with a solid background in pre- and post-operative care.

Nicholas Bruns, OD, FAAO
Ronald Carr, OD, FAAO
About Ronald Carr, OD, FAAO

Ronald Carr, OD, FAAO, earned his doctorate of optometry degree from the New England College of Optometry. He was the recipient of the Gold Key International Honor Society Award for leadership and was a member of the Beta Sigma Kappa Optometric Honor Society for four years.

Following graduation, Dr. Carr completed a one year fellowship in primary care at the New England College of Optometry and then trained at the prestigious Bascom Palmer Eye Institute for fourteen months. He has been with Midwest Eye Professionals since its inception in 1997.

Dr. Carr has and continues to lecture on a variety of ophthalmic and optometric topics to his colleagues. He is on the speakers’ panel for Alcon, Allergan, and Bausch and Lomb Pharmaceuticals.

Dr. Carr is a fellow of the American Academy of Optometry and is a member of its Illinois State Chapter. He is a member of the American Optometric Association and the Illinois Optometric Association. Dr. Carr also participates as an adjunct assistant professor for the Illinois College of Optometry.

Dr. Carr is an optometric member for the Blindness Prevention Eye Care Advisory Committee. He is also an affiliate of the Volunteer Optometric Services to Humanity (V.O.S.H.) and a member of the Palos Chambers of Commerce.

Ronald Carr, OD, FAAO
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