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Phakic IOL

Phakic IOL is an effective procedure for patients who have thin cornea, high myopia, high hyperopia or mild keratoconus.

The word “phakic” means that your natural crystalline lens is not removed from the eye.　A phakic intraocular lens (IOL) is placed into the eye. Accordingly, the phakic IOL implant functions as an internal contact lens and the view through the phakic IOL is natural and of a good quality. Phakic IOLs are used to treat severe myopia or hyperopia with or without astigmatism, or mild keratoconus.

Minamiaoyama Eye Clinic started performing phakic IOL surgery in 2000 and the number of surgeries has reached more than 850 in total.

Phakic IOL Suitability

Phakic IOLs are particularly suitable for the following candidates:

those who cannot undergo a LASIK or PRK due to severe nearsightedness, farsightedness or insufficient corneal thickness for LASIK; or
those who cannot undergo a laser refractive surgery due to keratoconus or other disorders

Advantages and Disadvantages of Phakic IOL

Advantages	Glasses or contact lenses will be unnecessary. Any discomfort with contact lenses will be eliminated. Quality of vision is usually better than that achieved with glasses or contact lenses. Astigmatism is corrected. Although the phakic IOL is intended to be permanent, the procedure is reversible, if desired.
Disadvantages	Phakic IOLs are made-to-order. It takes a few months to manufacture the appropriate phakic IOLs. Like any surgical procedure, Phakic IOL has risks associated with it. The following is a list of possible risks: ・Undercorrection or overcorrection ・Inadequate fixation of the lens ・Cloudiness of anterior capsule ・Attachment of cells to lens posterior surface

Types of Phakic IOL

There are two types of phakic IOLs―anterior chamber lenses which are placed in the anterior chamber of the eye between the iris and the cornea, and posterior chamber lenses which are placed in the posterior chamber behind the iris.

Anterior Chamber Phakic IOL
The Artisan phakic IOL manufactured by Ophtec BV (The Netherlands) is placed behind your cornea and above your iris. This phakic IOL, which is made of PMMA, functions as another focusing lens that provides high-quality, high-definition vision like that of a normal eye.

The Artiflex IOL has been developed by Ophtec BV, too. The central part of this IOL, through which the light passes, is made of silicone and the fixation points are made of PMMA. The Artiflex IOL is inserted into the eye through a small incision; this results in rapid visual improvement and induces a lesser degree of astigmatism.

Posterior Chamber Phakic IOL
The ICL manufactured by Staar Surgical (U.S.A.) is placed in the posterior chamber behind the iris and rests against the bag of crystalline lens. The ICL is made of collamer, the combination of collagen and HEMA polymer and inserted into the eye through a small incision; this results in rapid visual improvement.

Phakic IOL Exams and Surgery

Initial Eye Exam
During this examination, the doctor will determine whether you are a suitable candidate for phakic IOL surgery.

Instructions for Patients Wearing Contact Lenses
Contact lenses alter the shape of the cornea. Therefore, people who wear contact lenses will need to stop wearing them for a period of time before the final examination, depending on the type of contact lenses used. Following the below instructions will ensure the proper measurement of the refractive error in patients.

Hard or gas permeable lenses (HCL) should not be used for 4 weeks prior to the final examination.
Soft contact lenses (SCL) should not be used for 3 days prior to the final examination.
Any kind of contact lenses can be used the day before the surgery. Please do not use them on the day of the surgery.

Preoperative Final Exam
To order the appropriate phakic IOLs, a detailed visual acuity measurement is conducted. If you wear contact lenses, you should stop using them before the final examination, as mentioned above. During this visit, we will take a sample of your blood, which will be subjected to laboratory examination for infectious diseases.

Laser Iridotomy
A couple of weeks prior to the surgery, small openings are made in your irises by a laser to prevent an increase in the intraocular pressure. You will have to undergo an examination to check the condition of your eyes within one week after laser iridotomy.

Phakic IOL Surgery
If you wear contact lenses, you can use them the day before the surgery. You should not wear them on the day of the surgery. Implantation of the phakic IOL is an outpatient surgery that takes around 30 minutes.

A local anesthetic is instilled to sedate the eye.
A small incision is made in the cornea, through which the phakic IOL can be inserted.
The phakic IOL is inserted through the small incision into the proper position in your eye.
The small incision is closed with microscopic stitches if necessary.

Check-up Examination
Postoperative check-up examinations will be conducted at 1 day, 1 week, (2 weeks), 1 month, 3 months, 6 months, 1 year, 2 years, 3 years, 5 years, and 10 years after the surgery. Please contact the clinic in case you experience unusual symptoms or if your vision suddenly worsens.

Prices

The cost of Phakic IOL surgery on one eye is 600,000 JPY, which includes consumption tax.

Phakic IOL Outcome

The followings are the outcome of the phakic IOL at Minamiaoyama Eye Clinic in 2008.