Is Phakic Intraocular Lens (IOL) Safe?

Phakic IOL procedure
The phakic intraocular lens (IOL) is an alternate procedure to other refractive error procedures like LASIK and PRK (photorefractive keratectomy) eye surgery.

Phakic IOL is a relatively safe procedure but some possible complications following phakic IOL that may occur are:

What is phakic IOL?

The phakic intraocular lens (IOL) is an alternate procedure to other refractive error procedures like LASIK and PRK (photorefractive keratectomy) eye surgery. Phakic IOL also replaces the need to use eyeglasses and contact lenses, since it is permanent. It is used to correct severe myopia (nearsightedness). Phakic IOLs (PIOLs) are implantable intraocular lenses made of clear silicone or plastic, which is surgically placed in the eye that still contains a natural human crystalline lens. Hence, PIOLs are sometimes also called 'implantable contact lenses' (ICLs). The PIOLs function is similar to contact lenses worn on the surface of the eyes to correct nearsightedness. In some cases, PIOLs produce better and more predictable results compared to other laser refractive surgeries.

What are the two types of phakic IOL?

There are two FDA approved phakic IOLs currently available for the use in severe myopia and myopic astigmatism, the choice of which is made by the eye surgeon depending on the extent of the condition: 

Visian ICL: The Visian ICL is positioned in the posterior chamber, meaning it is placed behind the iris (the colored tissue in the front of the eye that contains the pupil in the center) )  and in front of the natural lens. It is made of a soft, biocompatible collagen copolymer, making it flexible and easily foldable for implantation, hence requiring a very small surgical incision.

Verisyse: The Verisyse is positioned in the anterior chamber, meaning it is placed in front of the iris. It is made of medical-grade plastic (polymethylmethacrylate) and is rigid.

What are the uses of phakic IOL?

Phakic IOLs are used to correct refractive errors which cannot be corrected by other refractive surgeries

The cornea and natural lens of the eye bend and focus light on the retina and create images on the retina for vision. This bending and focusing of light is also known as refraction. Refraction is affected in refractive errors, causing blurred or distorted vision. People who have myopia or nearsightedness have difficulty seeing distant objects and near vision is normal. In myopia, the light focuses in front of the retina and not on the retina. Eyeglasses and contact lenses correct this problem when used. Phakic IOLs is a permanent solution, causing the light to focus on the retina and replacing the need to use eyeglasses or lenses. 


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What is the difference between phakic intraocular lenses and intraocular lenses in cataract surgery?

Phakic intraocular lenses are implanted in the eye without removing the natural lens. Intraocular lenses used in cataract surgery  replace the cloudy, opacified natural lens that occurs in cataract. The natural lens is generally removed in cataract surgery.

How is phakic IOL done?

The procedure is done under local anesthesia. Intravenous sedation may be given as well. A flap is made, following which the phakic IOLs are surgically placed either between the cornea and the iris or just behind the iris, depending on the type of phakic IOL used. The natural lens is not removed. Phakic IOL is permanent and does not require any specific post-operative care besides the routine eye exams with the ophthalmologist (eye surgeon).