Phakic IOL

A phakic IOL like the visian ICL is one of the ideal ways to correct your vision and decrease your need for glasses or contact lenses. For many patients, a phakic IOL is the best choice for vision correction. The Eye Center of Northern Colorado, P.C. has been a pioneer and a leader for the phakic IOL in Colorado and the entire country.

Four out of every ten Americans suffer from Myopia, a condition more commonly called “nearsightedness.” Myopia means that the eye is malformed causing objects at a distance to be out of focus. This can occur if the eye is too long or if the cornea is too steep. Millions have found a cure for this disability through eye surgery.

The two most common surgeries to correct Myopia are laser eye surgery and a phakic IOL(Intraocular Lens) like the visian ICL. In laser eye surgery, a laser vaporizes away part of the cornea to change its shape and restore focus. In phakic IOLs, a small intraocular implant is placed inside the eye to restore proper focus.

The term phakic means lens. Phakic IOL means that you still have your natural lens (nothing has been removed) and a very thin phakic IOL has been added to correct the power. This differs from cataract surgery where your natural lens is removed before an intraocular implant is placed.

Myopia

Four out of every ten Americans suffer from Myopia, a condition more commonly called “nearsightedness.” Myopia means that the eye is malformed causing objects at a distance to be out of focus. This can occur if the eye is too long or if the cornea is too steep. Millions have found a cure for this disability through eye surgery. The two most common surgeries to correct Myopia are laser vision correction and phakic IOLs (Intraocular Lens). In laser vision correction, a laser vaporizes away part of the cornea to change its shape and restore focus. In phakic IOLs, a small implant is placed inside the eye to restore proper focus.

The term phakic means “lens.” Phakic IOL means that you still have your natural lens (nothing has been removed) and a very thin IOL has been added to correct the power. This differs from cataract surgery where your natural lens is removed before an IOL is implanted.

Phakic IOL vs Lasik

Some patients are best served by laser vision correction, others by a phakic IOL, and many would be fine candidates for eitherprocedure Phakic IOL: Implanted in front of the Iris. Your surgeon will need to examine the health of your eye and understand your lifestyle requirements so they can recommend the ideal approach for you. For example, I performed LASIK on my sister, but implanted a phakic IOL in my brother when it was time to correct their Myopia.

Do you Feel a Phakic IOL?

Patients do not feel the phakic IOL in their eyes the way they might feel contact lenses because the phakic IOL is on the inside of the eye and doesnt move, while a contact lenses sits on the outside of the eye where it can dry out and move around causing irritation. A phakic IOL offers a long-term solution to Myopia since it does not wear out and doens’t need to be replaced.

A phakic IOL can be placed just in front of the iris (the colored part of the eye) or just behind it depending on the style of implant chosen. There are several distinct advantages to correcting vision with a phakic IOL. First, many patients like the potential reversibility of the procedure because if the implant were removed, you would most often be back where you started. Second, you can check the implant powers ahead of time and make certain they are the exact intended power and of high optical quality. Third, placing the implant doesn’t weaken the strength and integrity of the cornea. Laser correction slightly weakens the cornea, so if you have a thin or a weak cornea you may not be a candidate for laser correction. Fourth, you can treat even high amounts of Myopia with a phakic IOL while there is a limit to how much Myopia you can treat with laser vision correction.

Verisyse

The first phakic IOL approved in the U.S. was the Verisyse lens. It comes in powers from -5 up to -20 of Myopia. This implant is placed inside the eye just in front of the iris and is held in place by tiny clips. The implant is made of rigid plastic called PMMA and implants of this style and material have been used in the world for over 30 years with good long term stability and safety.

On a personal note, I remember how much I looked forward to being able to offer this phakic IOL to my patients before it was FDA approved. Back in 2004 the big ophthalmology meeting for the year was held in San Diego. The company marketing the Verisyse anticipated FDA approval any day, but they were not allowed to train us in the U.S. until after approval. To solve this problem, they sent me along with a small group of U.S. surgeons across the border from the San Diego meeting to Tijuana where we trained with the lens. After the training, they dropped us off at the border and we had to walk back across to U.S. soil. The lens was approved several months later and I performed the first phakic IOL surgery in Colorado shortly thereafter.

Visian ICL

In 2005, the Visian ICL was approved. ICL stands for Intraocular Contact Lens, meaning it is a contact that is permanently implanted inside the eye. It is made out of a very soft and flexible collimer which is a 100% pure co-polymer containing a natural substance called collagen which makes the Visian ICL very well tolerated by the eye. The Visian ICL has ultraviolet protection built in which would help protect your natural lens and retina from the damaging rays of the sun.

The Visian ICL is available from -3 to -16 diopters of Myopia. The Visian ICL rolls up and enters the eye through a very small incision (about 1/8th of an inch) and then opens up inside the eye to its full size. This makes the Visian ICL procedure less invasive and the incision is so small that no sutures are required. Studies have shown a 99% patient satisfaction rate with the Visian ICL.

Cachet

There is a third phakic IOL called the Cachet. It was approved for use in Europe in 2008 and is currently seeking approval for the U.S. I was a principal investigator in this FDA trial and have had a very good experience with this implant. It is made out of acrylic, so it will also roll up and enter the eye through a small incision. It sits in front of the iris and is held in place by tiny foot plates that nestle in the angle of the eye.

Where does the Phakic IOL sit in the eye?

The Verisyse and Cachet lenses sit in front of the iris. Since they are clear they are only rarely visible cosmetically in just the right light. The Visian lens sits behind the iris and is clear so it is not detectable cosmetically. The phakic IOL procedure is a surgery so there can be risks which range from the annoying like halos and glare up to sight threatening risks like cataract or infection. Your surgeon will review the specific risks you face based on your eye health and the style of implant you choose.

The next step for patients wanting to find the best option for correcting their Myopia is to schedule an eye exam. The ideal scenario is to meet with a surgeon that performs both laser vision correction AND phakic IOLs so that you can have a thorough discussion about which method would be best for you. If I can provide any other information for you, please contact me through the comments section or find me on Facebook.

Risks of Phakic IOL

The Verisyse and Cachet lenses sit in front of the iris. Since they are clear they are only rarely visible cosmetically in just the right light. The Visian ICL sits behind the iris and is clear so it is not detectable cosmetically. The phakic IOL procedure is a surgery so there can be risks which range from the annoying like halos and glare up to sight threatening risks like cataract or infection. Your surgeon will review the specific risks you face based on your eye health and the style of implant you choose.

Phakic IOL Costs

Phakic IOLs are performed in an operating room with all the attendant costs of qualified nursing staff and anesthesia. In addition, the implantable contact lenses have specific costs associated. As a result, phakic iols tends to cost more than laser eye surgery where no implant or operating room costs are involved.

The next step for patients wanting to find the best option for correcting their Myopia is to schedule an eye exam. The ideal scenario is to meet with a surgeon that performs both the laser vision correction AND the phakic IOL procedure so that you can have a thorough discussion about which method would be best for you. If I can provide any other information for you about the phakic IOL, please contact me through the comments section or find me on Facebook.

Questions to ask your surgeon: