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    Phakic IOLs: Good benefit-to-risk ratio

    Three different lenses, each with unique features, provide optical quality and fast visual rehabilitation

     

    Take-Home Message

    The benefit-to-risk ratio of phakic IOLs is well balanced, according to one surgeon, who explained why phakic IOLs may be a good additional option for refractive surgery.

     

    Dr. Kohnen

    Frankfurt, Germany—The benefit-to-risk ratio of phakic IOLs is well balanced, according to Thomas Kohnen, MD, PhD.

    Though there is a risk of decreased endothelial cells counts and cataract formation in some eyes with certain phakic IOLs, the optical quality achieved with the IOLs is very good and the procedure is reversible, said Dr. Kohnen, professor and chairman, Department of Ophthalmology, Goethe-University, Frankfurt, Germany.

    The German standards for phakic IOLs are myopia over –6 D and hyperopia over +3 D, he noted. Borderline implications depend on the surgical goals and include myopia over –3 D and hyperopia of +2 D.

    “The most important factor for phakic IOLs are implant-specific regulations for the anatomy, including the anterior chamber, the endothelium, and patient age,” he said.

    Dr. Kohnen discussed the pros and cons of three phakic IOL designs:

    • The angle-supported AcrySof Cachet IOL (Alcon Laboratories).
    • The iris-fixated Artisan/Verisyse IOL (Ophtec/Abbott Medical Optics).
    • The sulcus-supported Visian ICL (STAAR Surgical).

    He has to date implanted a total of 1,300 phakic IOLs that include all three types.

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