Phakic Intraocular Lenses (cont.)
Are Phakic Lenses for You?
You are probably NOT a good candidate for phakic lenses if:
- You are not an adult. There
are no phakic lenses approved by the FDA for persons under the age of 21.
- You are not a risk taker.
Certain complications are unavoidable in a percentage of patients, and there are
no long-term data available for phakic lenses.
- You required a change in your contact lens or
glasses prescription in the last 6 to 12 months in order to
obtain the best possible vision for you. This is
called refractive instability. Patients who are:
are more likely
to have refractive instability and should discuss the possible additional risks
with their doctor.
- in their early 20s or younger,
- whose hormones are fluctuating due to disease such
- who are pregnant or breastfeeding, or
- who are taking medications that may cause
fluctuations in vision,
- You may jeopardize your career. Some jobs prohibit certain refractive procedures. Be sure to check
with your employer/professional society/military service before undergoing any
- Cost is an issue. Most
medical insurance will not pay for refractive surgery.
- You have a disease or are on medications that
may affect wound healing. Certain conditions, such
as autoimmune diseases (e.g., lupus, rheumatoid arthritis),
immunodeficiency states (e.g., HIV) and diabetes, and some medications (e.g.,
retinoic acid and steroids) may prevent proper healing after intraocular
- You have a low endothelial cell count or
abnormal endothelial cells. If the cells that pump the fluid
out of your cornea, the endothelial cells, are low in number relative to your
age, or if your endothelial cells are abnormal, you have a higher risk of
developing a cloudy cornea and requiring a corneal transplant.
- You actively participate in sports with a high
risk of eye trauma. Your eye may be more
susceptible to damage should you receive a blow to the face
or eye, such as a blow to the head during boxing or hit in
the eye by a ball during baseball. Your eye may be more
susceptible to rupture or retinal detachment,
and the phakic lens may dislocate.
- You only have one eye with potentially good
vision. If you only have one eye with good vision with
glasses or contact lenses, due to disease, irreparable damage, or amblyopia
(eye with poor vision since childhood that cannot be corrected with glasses or
contact lenses), you and your doctor should consider the risk of possible
damage and/or loss of vision to your better eye as a result phakic lens
- You have large pupils. If
your pupil dilates in low lighting conditions to a size that is larger than
the size of the lens, you have a higher risk of experiencing visual
disturbances after surgery that may affect your ability to function
comfortably or normally under such conditions (e.g., while driving at night).
- You have a shallow anterior chamber. If the space between the cornea and the iris, the anterior
chamber, is narrow, you have a higher risk of developing complications, such
as greater endothelial cell loss, due to implantation of the phakic lens.
- You have an abnormal iris. If your pupil is irregularly shaped you have a higher risk of
developing visual disturbances.
- You have had uveitis. If you have had
inflammation in your eye, you may have a recurrence or
worsening of your disease and/or may develop additional
complications, such as glaucoma, as a result
- You have had problems with the posterior part of
your eye. If you have had any problems in the back
part of your eye or are at risk for such problems, for
example, proliferative diabetic retinopathy (growth of
abnormal vessels in the back of the eye due to diabetes) or
retinal detachment, you may not be a good candidate for
phakic lens implantation. The phakic lens may not allow your
eye doctor to get a clear view of the back part of your eye,
preventing or delaying detection of a new or worsening
problem, and/or the phakic lens may prevent or make
treatment of a problem in the back of your eye more
The safety and effectiveness of phakic lenses have NOT been
studied in patients with certain conditions. If any of the
following apply to you, make sure you discuss them with your
- You have glaucoma (damage to the nerve
of the eye resulting in loss of peripheral and then central
vision due to too high pressure inside the eye),
ocular hypertension (high eye pressure), or
glaucoma suspect (some indications, but not clear,
that patient has glaucoma). You may have a higher risk of developing or
worsening of glaucoma as a result of phakic lens implantation.
- You have pseudoexfoliation syndrome (abnormal deposits of material in the eye visible on the
structures in the front part of the eye, such as on the front of the natural
lens and the back of the cornea). This syndrome is associated with glaucoma
and weakness of the structures holding the natural lens in place (the
zonules). You may have a higher risk of surgical complications and/or
complications after surgery if you have this syndrome.
- You have had an eye injury or previous eye
- Your need for visual correction is outside the
range for which the phakic lens has been approved.
Ask your eye doctor if the phakic lens that he or she
recommends for you has been approved to treat your
refractive error and/or check
FDA-Approved Phakic Lenses for the approved
- You are over the age of 45 years old.
Some phakic lenses have not been studied in patients over
the age of 45.