IOL Selection Using a Light Adjustable Lens in a Post-LASIK Painter With Color Sensitivity

This case focused on a 70-year-old female painter with declining near vision, a history of myopic LASIK, and strong preferences for spectacle independence and accurate color perception. Given her profession, the group discussed how artists and photographers may be particularly sensitive to color shifts, contrast changes, and dysphotopsias, including concerns around yellow-tinted and multifocal IOLs. Although monovision is often approached cautiously in older patients due to balance and depth perception concerns, this patient was open to trialing it. Higher-order aberrations in post-refractive eyes were reviewed, including whether they should influence candidacy for multifocal IOLs, though opinions varied on how heavily this factor is weighed in modern practice. The treating surgeon ultimately selected a light adjustable lens to allow postoperative refinement, resulting in successful monovision with patient satisfaction despite transient glare managed with YAG capsulotomy. The discussion also addressed alternative approaches, noting that many surgeons achieve excellent outcomes with multifocal IOLs in post-LASIK patients using modern biometry and formulas, while weighing cost, workflow, and logistical considerations associated with light adjustable lenses.