Phakic intraocular lens

Phakic intraocular lens (PIOL) is a type of eye surgical device implanted into the eye to correct refractive errors. Unlike traditional intraocular lenses (IOLs) used in cataract surgery, which replace the eye's natural lens, phakic IOLs are implanted without removing the natural lens. This procedure is primarily used for patients who are not suitable candidates for other forms of refractive surgery, such as LASIK or PRK, due to extreme myopia (nearsightedness), hyperopia (farsightedness), or thin corneas.

Types of Phakic IOLs

There are mainly two types of phakic intraocular lenses: anterior chamber phakic IOLs and posterior chamber phakic IOLs.

• Anterior chamber phakic IOLs are placed in front of the iris. This type includes the angle-supported and the iris-fixated phakic IOLs.
• Posterior chamber phakic IOLs are situated between the iris and the natural lens. The most common type of posterior chamber PIOL is the implantable collamer lens (ICL).

Indications

Phakic IOL implantation is indicated for patients with high degrees of myopia or hyperopia, where laser refractive surgery may not be the best option. It is also considered for patients with thin corneas or other corneal abnormalities that make laser surgery less viable.

Procedure

The implantation of a phakic IOL is a surgical procedure that typically takes about 15 to 30 minutes per eye. It is usually performed under local anesthesia. The specific steps of the procedure can vary depending on the type of phakic IOL being implanted. Generally, the process involves making a small incision in the eye, through which the lens is inserted and positioned correctly.

Risks and Complications

As with any surgical procedure, there are risks associated with phakic IOL implantation. Potential complications include infection, increased intraocular pressure, cataract formation, loss of endothelial cells, and retinal detachment. However, with proper patient selection and surgical technique, the risk of serious complications is low.

Benefits

The primary benefit of phakic IOL implantation is the correction of significant refractive errors, allowing patients to achieve good vision without the need for glasses or contact lenses. Many patients experience immediate vision improvement after the procedure, with further improvements occurring as the eye heals.

Aftercare

Postoperative care for phakic IOL implantation involves the use of antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation. Patients are typically advised to avoid strenuous activities and to protect their eyes from trauma. Follow-up visits with the ophthalmologist are crucial to monitor the healing process and to detect any potential complications early.

Conclusion

Phakic intraocular lens implantation offers a viable alternative to laser refractive surgery for patients with high degrees of myopia or hyperopia and those who are not suitable candidates for LASIK or PRK. While the procedure carries some risks, the potential benefits in terms of vision correction can be significant. As with any surgical procedure, careful patient selection and adherence to postoperative care instructions are essential to achieving the best outcomes.

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Phakic_intraocular_lens

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  Phakic intraocular lens

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  Intraocular lens under cornea, six years after installation (with flash)

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  Intraocular lens under cornea, six years after installation (no flash)