The Light Adjustable Lens: The Only Lens Designed to Be Customized After Surgery

If you have started researching cataract surgery, you may have learned that most lens options are selected before surgery based on detailed measurements of your eye and your vision goals. Your surgeon uses that information to select an intraocular lens designed to match those goals.

The Light Adjustable Lens, or LAL, gives patients another option. With the LAL, your vision can be fine-tuned after cataract surgery once you have had time to heal and experience your vision in everyday life. Instead of making every decision before surgery, you and your care team have an opportunity to adjust the lens afterward.

For someone who feels nervous about choosing the “right” lens before knowing what the result will feel like, that can be reassuring and the LAL represents the only IOL that allows you to test-drive your vision and play a role in your visual outcome. Additionally, we as doctors at VTV love the LAL because the calculations for cataract surgery can’t predict how any individual patient heals and this is the only IOL that overcomes that limitation. 

At Vance Thompson Vision in Sioux Falls, South Dakota, our ophthalmology  team has extensive experience with advanced cataract technology and vision research. Dr. Vance Thompson has served as the medical monitor lead or principal investigator in more than 100 clinical trials monitored by the United States Food and Drug Administration, helping evaluate new technologies and techniques in vision correction.

This guide explains what makes the LAL different, how the adjustment process works, who may benefit from it, and what you can expect along the way.

What Makes the Light Adjustable Lens Different From Other Cataract Lenses?

A cataract develops when the natural lens inside the human eye becomes cloudy. Cataract surgery removes that cloudy lens and replaces it with a clear artificial intraocular lens, or IOL.

With a basic lens implant, your surgeon uses measurements from your eye examination to calculate the lens power before surgery. These measurements may include the shape of your cornea, the length of your eye, your astigmatism, and your current eyeglass prescription.

Modern calculations are highly advanced, but every eye is different. Healing can affect the final result, and there is always some degree of prediction involved when selecting the lens before surgery. The Light Adjustable Lens changes that part of the process because it is the only intraocular lens that can be customized after cataract surgery. Importantly, the adjustment (customization) process does not involve additional surgery and adjustments are performed  in the office. 

Once your eye has healed, the team will evaluate your vision, measure your refraction and learn how your vision is performing at different distances and in different lighting conditions. If an adjustment would help, controlled ultraviolet light is used to fine-tune the power of the implanted lens. In plain language, you get to experience your new vision before the lens is permanently finalized.

That ability can give some patients more confidence in the process, especially when small changes in distance vision or overall visual perception matter to them.

How Does the Adjustment Process Actually Work?

The Light Adjustable Lens is implanted during cataract surgery much like other intraocular lenses. The difference begins after surgery.

First, your eye needs time to heal. Your vision and refraction may continue changing during the early recovery period, so the team waits until the eye is stable before beginning adjustments. When you return for your light treatment appointments, your vision is checked, your refraction is obtained, and you will talk with the team about how you are seeing in real life.

Maybe your distance vision feels great, but computer work could be clearer. Maybe seeing far away without glasses is your main priority. Or perhaps you and your doctor have discussed blended vision, where each eye is targeted slightly differently to provide a useful range of vision. Those real-world experiences help guide the adjustment process.

Once your treatment goal is confirmed, a specialized Light Delivery Device directs controlled ultraviolet light (UV) onto the lens after your eyes are dilated. The targeted UV light directed at your lens is a non-invasive treatment that lasts up to 120 seconds.  The light changes the shape and focusing power of the photoreactive silicone material inside the LAL. There is nothing surgical about an adjustment and it is completely non-invasive.

Lens power is measured in units called dioptre, but you do not need to interpret those yourself. Your care team uses these measurements to determine whether your lens may benefit from additional fine-tuning.

More than one adjustment appointment may be needed. Between visits, you have time to experience the change and talk with the team about whether another adjustment would be helpful. Once you and your care team are satisfied with the vision, final lock-in treatments are performed to permanently stabilize the lens power over the course of two separate visits.

Patients also need to follow the UV-protection instructions provided by the team during the adjustment period. Special UV-protective glasses help protect the adjustable lens from unintended ultraviolet exposure and should be worn as directed by your care team through the completion of the lock-in process. 

Who Is the Best Candidate for the Light Adjustable Lens?

There is no single cataract lens that is best for every patient. The LAL may be especially appealing to someone who values precision and wants the ability to participate in fine-tuning their vision after surgery. 

It may be worth discussing if you:

• Want a high level of customization after cataract surgery
• Have specific goals for distance or everyday vision
• Want to experience your vision before the final prescription is locked in
• Have had previous refractive surgery, such as LASIK or radial keratotomy
• Have astigmatism that may benefit from additional refinement
• Have factors that make predicting the final prescription before surgery more challenging
• Are comfortable returning for the required adjustment appointments
• Are able to follow the UV-protection requirements during the adjustment period

Previous LASIK or other refractive surgery can make cataract lens calculations less accurate because those procedures change the shape of the cornea. The LAL is the only IOL that overcomes the limitations of IOL power calculations owing to the opportunity to make adjustments after the eye has healed rather than relying entirely on pre-surgical calculations.

The lens may also appeal to patients with demanding visual needs. Maybe you drive often and clear distance vision is especially important. Maybe you spend much of your day looking at a computer. Or perhaps you simply want more involvement in deciding how your final vision is set.

Your consultation is where the team can help you weigh those factors and determine whether the Light Adjustable Lens is appropriate for your eyes and vision goals.

How Does the LAL Compare to Multifocal and EDOF Lenses?

Patients often ask whether the LAL is “better” than a multifocal or extended depth of focus lens. The more useful question is which lens better matches your eyes and your goals.

The Light Adjustable Lens focuses on precision and adjustability. Its power can be fine-tuned after surgery based on how the eye heals and how the patient experiences their vision. Some patients also use the LAL for blended vision, where one eye is targeted for distance and the other provides additional support for closer tasks.

Multifocal lenses work differently. They are designed to provide focus at multiple distances, often including near, intermediate, and far vision. Extended depth of focus, or EDOF, lenses are designed to provide a continuous range of useful vision at distance and intermediate.

For a patient whose main goal is having a broad range of vision without glasses, multifocal or EDOF technology may deserve consideration. For a patient whose priority is being able to fine-tune a prescription after surgery, the LAL may have more appeal. And for some people, a basic monofocal corrective lens may still be the best choice.

Eye health matters, too. The cornea, retina, optic nerve, existing eye conditions, and previous surgery can all influence which lens is appropriate. The goal is not to choose the most advanced-sounding technology. It is to choose the technology that makes sense for your eye and the way you want to use your vision.

What Does the Light Adjustable Lens Cost and Will Insurance Cover It?

Cost is an important part of the cataract surgery conversation, and patients deserve clear information before making a decision. The Light Adjustable Lens is an advanced cataract lens.

When cataract surgery is medically necessary, Medicare generally covers the surgery and a conventional intraocular lens. Private insurance coverage varies by plan, and additional costs associated with advanced lens technology or related non-covered services may be the patient’s responsibility.

At your consultation, the Sioux Falls patient counseling team will explain which costs may be submitted to insurance and which costs would be your responsibility. You will have time to ask questions and understand the financial side before deciding whether the LAL fits your needs.

Why Is Vance Thompson Vision in Sioux Falls Uniquely Qualified to Offer the LAL?

Vance Thompson Vision has a long history of working with advanced cataract technology and participating in clinical research, giving the Sioux Falls team experience that extends beyond simply implanting a lens. With the Light Adjustable Lens, that experience includes a unique understanding of patient selection, how different eyes respond, how to interpret post-surgical measurements, how healing can affect the final result, when an adjustment may help, and when another cataract lens may be a better fit. Data from LAL surgeries performed at the Sioux Falls location has led to multiple peer-reviewed publications to help surgeons around the world better understand how to use the LAL. 

The Sioux Falls team has spent over a decade helping patients navigate those decisions. That combination of research experience and everyday patient care gives patients access to a team that understands the LAL throughout the process, from initial lens selection and surgery to adjustments and final lock-in treatments.

What Should You Expect at Your LAL Consultation in Sioux Falls?

You do not need to walk into your appointment already knowing which cataract lens you want. That is what the consultation is for.

Your visit includes a comprehensive eye examination and detailed testing to help the team understand your cataract, cornea, astigmatism, visual acuity, eyeglass prescription, and overall eye health. The team will also review your medical history, previous eye procedures, medications, and any current eye therapy or treatments that may affect your plan.

But the conversation matters just as much as the measurements. How do you use your vision every day? Do you drive frequently at night? Do you spend hours at a computer? Is reading important to you? Do you work in changing indoor or outdoor lighting? Are you comfortable wearing glasses for certain activities, or is reducing your dependence on them one of your biggest priorities?

Those details give the team useful information about which lens may fit your lifestyle. Your cataract evaluation may involve an optometrist working closely with Vance Thompson Vision’s Sioux Falls surgeons. This team approach helps connect your testing, recommendations, surgical planning, and follow-up care.

And you do not need to make a decision immediately. The goal is to help you understand your options, ask questions, and feel comfortable before moving forward.

Ready to Find Out If the Light Adjustable Lens Is Right for You?

If cataracts are making driving, reading, working, or enjoying everyday life harder, you do not have to choose a lens on your own. A cataract consultation can help you understand what is changing in your vision and whether the Light Adjustable Lens or another option fits your eyes and your goals. 

Not sure which vision correction option may be right for you? Take our Vision Correction Quiz to explore your options and learn more about what may fit your needs.

If you are ready to talk with our team, schedule a cataract consultation online.

Vance Thompson Vision Sioux Falls
3101 W. 57th St.
Sioux Falls, SD 57108 

The Sioux Falls team is here to give you clear answers, explain your options in simple terms, and help you feel comfortable with the decision you make for your vision.

Medically Reviewed by:
Tanner Ferguson, MD · Ophthalmologist 
Board-certified, fellowship-trained ophthalmologist specializing in cataract, cornea, glaucoma, refractive surgery, and vision research. 
Last reviewed Aug. 10, 2026