Phakic IOL

Phakic Intraocular Lenses (IOLs) are used to treat moderate to high myopia (nearsightedness) in patients who are not suitable candidates for laser vision correction procedures like LASIK or PRK. Phakic IOLs are designed to be implanted inside the eye without removing the natural lens, which remains in place (hence the term "phakic," meaning the natural lens is retained). The primary aim is to help focus light directly onto the retina, improving vision for people with significant myopia.

Key Points about Phakic IOLs for Myopia:

1. Indications:

  1. Typically used for patients with moderate to severe myopia (generally between -5.00 D and -20.00 D or more) who may not be ideal candidates for LASIK due to thin corneas or very high prescriptions.

  2. Also considered for patients with stable vision over a certain period (usually around a year), as fluctuating prescriptions could reduce the procedure's effectiveness.

2. Types of Phakic IOLs:

  1. Anterior chamber IOLs (AC-IOLs): These are placed in the space between the cornea and the iris.

  2. Posterior chamber IOLs (PC-IOLs): These are placed behind the iris but in front of the natural lens. An example of this is the Visian ICL (Implantable Collamer Lens).

3. Procedure:

  1. Phakic IOL implantation is a relatively quick surgical procedure that takes about 20-30 minutes per eye.

  2. It is generally performed under local anesthesia (numbing eye drops), and patients can often resume normal activities within a few days after surgery.

  3. The IOL is inserted through a small incision in the cornea, and the lens is positioned to correct refractive errors.

4. Benefits:

  1. Reversible: Unlike LASIK or PRK, the procedure is reversible. The IOL can be removed or replaced if needed.

  2. Minimal tissue removal: No corneal tissue is removed, preserving corneal integrity.

  3. Improved vision: Most patients experience significant improvement in their vision, often achieving 20/20 or near-perfect vision.

5. Risks and Complications:

  1. Infection: As with any surgery, there is a risk of infection.

  2. Increased intraocular pressure: Phakic IOLs may sometimes increase the risk of glaucoma.

  3. Cataracts: Over time, there is a possibility of cataract formation due to changes in the natural lens.

  4. Endothelial cell loss: Phakic IOLs in the anterior chamber can cause a reduction in the endothelial cells on the back surface of the cornea, leading to corneal decompensation in rare cases.

  5. Halos and glare: Some patients report seeing halos around lights, especially at night.

6. Follow-up:

  1. Patients typically need to undergo regular eye check-ups post-surgery to monitor eye health, including intraocular pressure and lens position.

Who is an ideal candidate for Phakic IOLs?

  • Adults aged between 21-45 with stable vision.

  • Those with myopia greater than what can be treated safely with laser surgery.

  • Patients who may have thin corneas or other contraindications for laser procedures.

Phakic IOLs provide an excellent option for individuals who want to reduce dependence on glasses or contact lenses but are not suitable candidates for corneal refractive surgery.

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