Phake Intraokularlinsen

Abstract

Phakic intraocular lenses (PIOLs), which are located closer to the eye's nodal points than the anterior corneal surface, can provide superior optical quality for higher corrections because of retention of normal prolate corneal asphericity and larger effective optical zones. Improvements in the material and design of phakic intraocular lenses and their insertion devices combined with advances in the understanding of the anatomical and physiological interactions of the PIOLs with intraocular structures, have increased safety and efficacy. Safety of these implants over the long term remains a concern, but in several situations PIOLs are the refractive correction of choice. The purpose of this review is to compare the different types of PIOLs regarding outcome and complications. Improvements in imaging technologies should improve the accuracy of ICL sizing and allow more precise prediction of effective lens position with more accurate power calculation. It is important to inform patients that phakic lens surgery only corrects the refractive aspect, and that the refractive error itself as well as the changes by surgery still has the potential for serious complications.

Foldable iris-fixated phakic intraocular lens implantation for the correction of myopia: Two years of follow-up

“…Iris-fixated pIOLs have been associated with several surgical complications such as elevation of IOP, cataracts, pigment deposits, pupil ovalization and chronic anterior segment inflammation. [20] In this study, elevation of IOP was observed in three eyes, all of which have responded well to topical antiglaucoma drops. Glaucoma may be related to the design of pIOL or elevation of IOP may be associated with chronic anterior segment inflammation caused by iris-fixated pIOLs.…”

“…Additionally, a shallow anterior chamber, extensive eye rubbing, or IOL dislocation resulting from inadequate iris enclavation are among several factors that may cause significant endothelial cell loss in eyes with iris-fixated pIOL. [20] Progressive endothelial damage may be associated with potential mechanical contacts between the pIOL and corneal endothelium. Several studies have reported short- and long-term complications related to these lenses.…”

Morphologic Changes in the Anterior Segment using Ultrasound Biomicroscopy after Cataract Surgery and Intraocular Lens Implantation

“…There have been several studies showing the usage of UBM in cornea, lens surgery, and pathophysiology of glaucoma (6–7–8–9–10–11–12). Based on these studies, it is possible to get important information on dynamic functions of iris, accommodation, presbyopia, glaucoma, and other aspects of anterior segment physiology.…”

Preoperative simulation of postoperative iris-fixated phakic intraocular lens position and simulation of aging using high-resolution Scheimpflug imaging

“…The foldable model (Artiflex/Veriflex), which can be implanted through a self-sealing 3.2 to 3.5 mm clear corneal incision, is available in Europe. 1,2 Ensuring safe intraocular distances between the pIOL and crucial intraocular tissues (eg, corneal endothelium and crystalline lens) postoperatively is mandatory for the long-term safety of this type of refractive correction. To exclude poor candidates for pIOL implantation (ie, those with a protruding iris or a poor peripheral anterior chamber depth [ACD]), careful preoperative selection is required.…”