Phakic IOLs: Intraocular Lens Implants for the Correction of Severe Myopia and Hyperopia


 

 

Severe nearsightedness and farsightedness can also be corrected with the implant of an additional synthetic lens into the eye, which thereby corrects the existing refractive error.

Phakic IOLs are typically used when the procedures of corneal surgery cannot be performed or are at their limit, for example because the cornea is too thin.

Why synthetic lenses?

Synthetic lenses, which are implanted into the eye, are used for the correction of severe to extreme nearsightedness or farsightedness. Today, they are mainly used for the correction of severe nearsightedness exceeding approximately –10 diopter. Combined with the LASIK procedure, even more severe refractive errors and a potentially pre-existing astigmatism can be corrected.

Synthetic lenses either are implanted into the eye in addition to the eye’s natural lens (ICL/Artisan), or synthetic lenses replace the eye’s natural lenses (CLE). In Germany, the ICL has been used for 5 years and the Artisan lens for 10 years. Synthetic lenses have been shown to be a sensible complement to the other procedures of refractive surgery.

The goal of synthetic lenses is to provide freedom from the need for eyeglasses or contact lenses.

How do phakic intraocular lenses work?

Synthetic lenses are either implanted into the eye in addition to the eye’s natural lens, or the eye’s natural lens is replaced with a synthetic lens. In both cases, a small incision (approximately 3 – 5 mm) is placed at the periphery of the cornea.
The new Veriflex pIOL is flexible and therefore foldable, which reduces the incision needed to 3.2 mm.

In the first case, the synthetic lens is placed into the anterior eye chamber through the incision, and it is secured into place on the iris or between the posterior surface of the cornea and iris with two small flexible hooks. For lens exchanges, first the eye’s natural lens is removed by ultrasound, and it is then replaced with a synthetic lens as described above.

Phakic lenses can be placed either in the anterior chamber of the eye between cornea and iris or in the posterior chamber behind the iris and in front of the natural lens. We have envoloped an flash animation demonstrating both procedures for you.

Simulate your lens implantation here!

 

Phakic intraocular lens implants are known for the high potential of exact predictability, the reproducibility of the surgical success and the reversibility of the procedure. One of the factors contributing to the safety of this procedure is the fact that the intraocular anatomy or physiology of the eye is not changed. The center of the cornea is not touched prior to surgery and nothing about the anatomy of the eye is changed.

   
         
 

For whom are synthetic lenses suitable?

Synthetic lenses such as ICL, Artisan, Verisyse lenses are mainly used for the correction of severe to extreme nearsightedness (exceeding approximately –8 diopter) and of severe to extreme farsightedness (exceeding approximately +5 diopter). Younger patients, who do not yet need reading glasses, generally receive a synthetic lens implant while keeping their eye’s natural lens. For older patients, it is usually better to exchange the eye’s natural lens with a synthetic lens of the appropriate prescription.

The severity of the refractive error, the diameter of the pupil when dilated in darkness and the thickness of the cornea as well as some other parameters must be taken into consideration. These parameters are assessed at your initial eye exam at one of the FreeVis LASIK Centers. In a detailed consultation with you, we will discuss which procedure best suits your needs.

For whom are synthetic lenses not suitable?

Generally, patients with chronic and progressive disorders of the eye such as glaucoma and certain retinal disorders as well as patients younger than 18 years old should not receive synthetic lenses.

Is an enhancement procedure possible?

Yes! Generally, the implant of a synthetic lens reduces the refractive error significantly. However, a total freedom from wearing eyeglasses cannot be achieved in all cases. If a refractive error remains after a synthetic lens implant, it can be corrected with a laser surgery, also known as LASIK.

   
         
 

Treatment costs

Costs for the removal of the eye’s natural lens and for the replacement with a synthetic lens are only covered if you have an opaqueness of the eye’s lens, also known as cataract. If you only choose this surgery in order to be free from the use of eyeglasses, this procedure is considered to be a procedure of refractive surgery and is not reimbursable.

In this case, the costs for the multifocal synthetic lenses and for the surgery are not covered by public or private health insurances. This fact also applies to the necessary preoperative exams and postoperative checkups up to 3 months after surgery. For the same reasons, costs for a potential enhancement LASIK procedure are not covered, either. The calculation of treatment costs is made in accordance with the German coding system for the calculation of medical services (Gebührenordnung für Ärzte – GOÄ).

Please feel free to inquire about the costs for a surgery to implant an intraocular lens.

   
         
 

Which problems can occur with synthetic lenses?

When the pupil is dilated at dawn and at dusk, the refraction of rays of light at the edge of the synthetic lens can lead to an increase in glare.

Additionally, long-term results dating back numerous years are not yet available for some of the newer and more modern synthetic lenses. Finally, the procedure involves a surgery in the inner eye, meaning that in extremely rare cases, severe side effects cannot be excluded.

What can you do to see well with synthetic lenses?

  • Do not rub on your eyes for the first few days after surgery!
  • Apply the eye drops on a regular basis as prescribed by your physician; only use the eye drops for the amount of time specified by your physician; extended use of this powerful medication may be harmful to your eyes.
  • Keep your appointments for your postoperative eye exams.
  • Schedule a checkup once a year so that potential long-term effects can be detected early.
  • Contact your physician immediately if you experience severe pain or a sudden decrease in vision.

Which problems may occur that are beyond my control?

  • Glare and halos at twilight and at night
  • Infection, pupillary distortion, cataract, secondary glaucoma, corneal opaqueness
  • Secondary cataract