Refractive Surgery - Phakic IOL

High myopia or high minus power is becoming a rapidly increasing medical and social problem. Permanent power correction is possible today by using laser (LASIK/PRK) or implantable collamer lens (ICL/Phakic IOL). Phakic IOL surgery is a procedure in which a very thin and soft lens is placed inside the eye, which works along with the natural lens of your eye to provide a crisp and clear spectacle free vision.  The entire procedure is painless and takes only around 10 minutes.

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Who is eligible for ICL/ Phakic IOL?

  • Anyone with minus power who wishes to get rid of spectacles can undergo eligibility screening test at our hospital. A number of tests are done to determine the suitability of your eye for this procedure.
  • Age must be over 18 years, and power should be stable in the last 6 months
  • No other eye disease such as cataract, glaucoma, retinal or optic nerve pathology should be present
  • Phakic IOL is also possible for those in whom LASIK is not suitable (very high power/ thin cornea)

Which is better - LASIK or ICL?

  • LASIK is a procedure in which an excimer laser is used to remodel the shape of your cornea, thus removing your power.
  • Your doctor will recommend after your screening test which procedure is better suitable for your eyes.
  • If your eyes are suitable for either procedure, the final choice lies with the patient after understanding all benefits and risks.
  • Phakic IOL offers the extra advantage of being a reversible procedure, and no impact on corneal nerves, leading to lesser dry eye symptoms.

Can power come back after ICL/Phakic IOL procedure?

  • Any refractive procedure, including Phakic IOL removes the total power which is present in your eye at the time of examination.
  • Therefore, it is recommended to opt for this procedure only once your power has become stable, so that power does not increase afterwards.
  • However, in a small proportion of patients, power may continue to increase in its natural process even after surgery. Unfortunately, this cannot be predicted beforehand. However, in most instances, this increase is much smaller compared to the original power.
  • Power for near vision will come in its natural process at the age of 40 years, as for all other individuals.

Will this lens be present in my eyes for lifetime?

  • ICL/Phakic IOL once placed, can remain inside the eyes for a long period of time.
  • It is usually removed only once cataract has developed in your eyes. At that time, the ICL will be explanted along with the removal of your natural lens, and an artificial lens will be placed like after any cataract surgery.

What are the tests done for PhakicIOL?

  • The tests done for Phakic IOL include -
    • Complete eye examination
    • Accurate power assessment
    • Intra ocular pressure measurement
    • Retinal evaluation by Indirect ophthalmoscopy and OCT (Macula)
    • Corneal endothelial cell count by Specular microscopy
    •  Anterior chamber depth by Pentacam
    • White -to -white measurement by digital calliper

What are the possible risks after ICL/Phakic IOL surgery?

  • Phakic IOL surgery is a very safe procedure with high success rate.
  • However, in a small number of patients, the following risks are possible:
    • Rise in intraocular pressure
    • Cataract formation
    • Infection in the eye.
  • Management of any of these complications is possible, and in rare cases, even the Phakic IOL may be removed if required.

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