The phakic IOL procedure involves inserting a thin lens inside the eye to correct very high amounts of myopia (nearsightedness) or hyperopia (farsightedness).

This procedure is usually reserved for patients whose refractive error is too severe to be corrected by LASIK surgery or for patients whose corneas are too thin for LASIK, PRK or epi-LASIK.

The word phakic (pronounced fay'-kick) means the eye's natural crystalline lens (located behind the iris) remains intact. It is not removed in the procedure, as it would be in cataract surgery. "IOL" is an abbreviation for intra-ocular lens. The phakic IOL procedure, then, involves placing a small lens inside the eye, while the eye's natural lens remains intact.

There are two basic types of phakic IOLs. One type (the one we'll discuss here) is an anterior chamber lens that is attached to the front of the iris. (The anterior chamber of the eye is the area between the back surface of the cornea and the front surface of the iris. It's filled with a clear fluid called the aqueous humor.) The most popular anterior chamber phakic IOL is the Verisyse lens (Advanced Medical Optics, Santa Ana, CA).

The second type of phakic IOL is called an Implantable Contact Lens, or ICL. This type of intra-ocular lens is placed between the iris and the natural crystalline lens of the eye. To learn more about ICLs, visit our ICL page.


The Verisyse phakic IOL procedure

Implanting the Verisyse phakic IOL is an outpatient procedure that takes approximately 15 to 30 minutes. Usually, one eye is treated at a time.

1. You will be asked to arrive at the surgery center about one hour prior to your procedure.
2. Once you have checked in, you may be offered a sedative to help you relax.
3. The area around your eye will be cleaned and a sterile drape may be applied.
4. Eye drops will be applied to your eye to reduce the size of the pupil
5. Eye drops and/or a local anesthetic will be used to numb your eye.
6. A small retainer device will be placed between your eyelids to keep you from blinking during the procedure.
7. A small incision is made in the peripheral cornea and the Verisyse lens is inserted into the anterior chamber of the eye.
8. The Verisyse lens is centered in front of the pupil and is gently attached to the front surface of the iris.
9. Dissolvable stitches may be used to seal the corneal incision. (In some cases, stitches are not required.)

Considerations after phakic IOL surgery

• After surgery, a temporary protective shield will be placed over your eye to protect it for the first few hours after the procedure.
• The results of the surgery are almost immediate, but your vision will probably be a little blurry from the anesthesia.
• You'll need someone to drive you home after the procedure.
• You should relax for the rest of the day after surgery.
• You may experience some discomfort after the anesthesia wears off, but this is usually relieved effectively with an over-the-counter pain reliever.
• Most patients resume normal activities within a day or two.

Risks and complications of phakic IOL surgery

According to Advanced Medical Optics (AMO), "With over 18 years of use and 150,000 procedures performed worldwide, results prove that the Verisyse design is safe and effective for very nearsighted people who are tired of thick glasses and are not candidates for Custom LASIK." [1]

Though the risks of phakic IOL surgery are low, potential complications include:

• Inflammation
• Infection
• Cataracts
• Retinal detachment
• Corneal damage

If you are considering phakic IOL surgery, be sure to discuss the risks and potential complications of this procedure with your surgeon as part of your pre-operative consultation.


Other information about phakic IOL surgery

In addition to being able to correct higher prescription powers than LASIK, another advantage of the phakic IOL procedure is that it's completely reversible. If vision is poor or other complications develop, the Verisyse intra-ocular lens can be removed or replaced at a later date.

The cost of the Verisyse phakic IOL procedure is significantly higher than LASIK surgery. It runs approximately $4,000 to $5,000 per eye, and (like LASIK) it's not covered by most medical insurance plans.


Source: www.visioninfocus.com. (AMO's website about the Verisyse phakic IOL). Access date: Jun 14, 2006.