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    Consider phakic IOLs for correcting myopia, surgeon says

    San Diego—Phakic IOL implantation is as potentially viable a means to correct myopia as LASIK/PRK or refractive lens exchange, said Sonia H. Yoo, MD.

    Among the advantages of phakic IOLs are they can correct high degrees of ammetropia, they preserve accommodation, and they result in fewer higher-order aberrations than other methods, she noted, speaking at World Cornea Congress.

    Related: Bean-shaped rings offer capsular support where none exists

    But they’re not perfect, and they do require intraocular surgery, bringing with them all the potential risks of incisional surgery, said Dr. Yoo, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine.

    Current phakic designs include iris-supported anterior chamber lenses (AMO’s Verisyse is approved in the United States, while its Artiflex is not), and angle-supported anterior chamber lenses (Alcon’s AcrySof Cachet, currently in phase III studies). STAAR Surgical’s Visian ICL is the only approved posterior chamber lens (implantation needs to be between the anterior capsule and the iris, Dr. Yoo said). 

    The Hole ICL and Toric ICL are not yet approved, although the latter is under FDA review.

    The Hole ICL “is designed to prevent pupil block and obviates the need for peripheral iridotomy,” she said.

    The Verisyse has been approved since 2004, and the FDA study results showed almost all patients had 20/40 after 3 years, but only half had an improvement in vision, and 6% had a loss of 1 or 2 lines. Complications in the FDA study ranges from a 1.8% endothelial cell loss rate per year to iritis in the early postoperative period and implant decentration.

    The Visian has been approved since 2005, and surgical implantation vaults the lens over the lens capsule to minimize the risk of cataract formation.

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