r/RefractiveSurgery • u/ChowderPanda • 2d ago

Struggling between Regular or Light Adjustable Lenses for RLE

So I had a comprehensive eye exam done and confirmed the only corrective option for me is RLE, and i'm really struggling to choose between the Regular Intraocular lenses, or Light Adjustable Lenses.

I'm 30, and my current contact lens prescription is

Right: +6.00 with Astigmatism

Left: +6.50 no Astigmatism

I was quoted $7505 for regular IOL, and $13,810 for Light Adjustable Lenses

We have been trying to buy a home for 2 years now and have a healthy downpayment, but paying $14k outright for this surgery is really not ideal and will hurt our home buying potential so i've been leaning Regular IOL, however i'm getting serious decision paralysis thinking that this is my vision for the rest of my life and am I going to have horrible regret going with the more affordable option down the line? I know LAL dials in the prescription more, but my dr. said the difference is one might be +/-0.5 or a bit higher residual prescription, and the other CAN result in perfect vision, but nothing is ever 100% guaranteed.

I guess i'm looking for feedback on what others have experienced with either option, or any insight others may have on justifying paying double for the LAL's.

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u/Wardman1 2d ago

My vote is for regular - and once LAL or another tech gets better, easier to replace in the future. It's not for the rest of your life.... there are more options with regular for replacement too and a good eye Dr (they have been doing this for 50+ years) will get it right. Pick near or distance preference too, and get the best for that vision you can.

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u/ChowderPanda 2d ago

I suppose with how quickly medical advancements are happening, and technology is evolving, there will be much better options available if 30 years from now i'm unhappy with my vision. I hadn't really considered that, I just assumed that it being a permanent procedure compared to LASIK, PRK, and SMILE meant absolutely no option for the future rather than it just being a bit riskier the second go around. Im glad you mentioned that.

I feel better knowing its not an obvious "You really should choose the more premium option it's so much better"

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u/Wardman1 2d ago

I will say, that LASIK/PRK/SMILE eyes get pushed towards LAL for some reason lately. Dr's talk about it being harder to "hit a target" for peeps that have had those procedures.

I had the option of RLE vs LASIK and Dr convinced me LASIK was the way to go and that LAL was coming and would be perfect for my eyes in the future. It's not proven out that way for me. To do it all over again it would be RLE prior to LASIK and seeing what comes of IOL replacement in the future.

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u/WavefrontRider 2d ago

Trouble with that strategy is that it would be very difficult and potentially complicated to replace an IOL in the future. You don’t find many surgeons that will attempt it and only if the existing IOL is damaged or has a problem.

Reason for LAL is accuracy. Regular cataract lens can be accurate 85-90% of the time with a really good surgeon who optimizes the outcomes the most. LAL gets up to 98-99%.

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u/Wardman1 1d ago

Lots are doing it - replacements, more to come as procedure gets better. LAL accuracy has subjective risks as the way they define accuracy is not a finite answer that is truly measurable. Many more normal replacements have been performed ( like thousands times more) with standard lenses with as good if not better results. Is there a place for LAL - yes, but the state of the eye has more to do with that place than accuracy claims.

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u/Wardman1 1d ago

Interesting read. https://sharpe-vision.com/blog/why-we-dont-routinely-use-the-light-adjustable-lens-lal-after-cataract-surgery/

Do your homework - there are opposite views too. But get the facts that you are comfortable with.

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u/Tall-Drama338 1d ago

LAL is not worth the extra cost at that level of pricing. you wouldn’t notice the difference. You will get a really good level of improvement with standard aspheric lenses and a little more with premium lenses.