Is it Worth it to Get Phakic IOLs?
When you’re considering any elective medical procedure, you need to know the risks, and weigh them against the benefits. The choice of whether or not to have an elective procedure is very personal, and every person will make their choice differently. Here, we’ll discuss the major risks and benefits of having phakic IOLs placed.
An intraocular lens is an artificial lens that is placed within the eye. The term “phakic” refers to the natural lens being left in place and the intraocular lens added (this differs from refractive lens exchange, in which the natural lens is removed and replaced). Phakic IOLs are sometimes referred to as implantable contact lenses (ICLs). For more on what it’s like to have phakic IOLs placed, please see Phakic Intraocular Lens Implants (IOLs): the Procedure and Recovery.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the provider who will perform your procedure if you decide to proceed.
Any treatment has risks, and it’s important to be aware of them so that you can weigh them against the benefits.
There is a risk of retinal detachment after placement of phakic IOLs. This risk is increased in people who have severe myopia (nearsightedness). Retinal detachment is usually treatable with further surgery, but still may lead to eye damage and potentially to blindness.
There is also a risk of other problems with the eye. If there’s damage to the nerves in and around the eye, you may experience a droopy eyelid, which may be permanent. There is a chance of bleeding or fluid collecting within the eye, which raises the eye pressure and may also potentially lead to blindness. The rise in eye pressure may require surgery, long-term medications, or both, and may damage the eye irreversibly. Because the eye is being cut, there is a risk of infection, which may require antibiotics and could also cause permanent damage to the eye.
There are also potential risks associated with the intraocular lens itself. The lens may become dislocated, which would make it difficult or impossible to see, and would require an additional surgery to replace the lens. Sometimes, there are other difficulties with the artificial lenses. There may be glare or halos around lights, particularly at night (similar to the most common side effects of LASIK and other laser procedures on the cornea), and vision is sometimes hazy through the IOLs. The prescription in the newly placed lens may also be inaccurate, which could require you to continue to use glasses or contacts to achieve good vision.
There is also a risk of corneal clouding. The cells that are responsible for maintaining the cornea, the clear part at the front of the eye, slowly degrade over the lifetime, and the cornea becomes cloudy when they are gone. Because this happens so slowly, most people die before they experience corneal clouding, but there is some evidence that phakic IOLs speed the process of cell loss, which could lead to the cornea becoming cloudy sooner.
Additionally, because phakic IOLs have only been available for about ten years, the long-term effects of having them are unknown. There could be additional risks that have not yet been discovered.
While refractive surgery to place IOLs does have risks, its benefits are also significant, and the majority of people who receive phakic IOLs are satisfied with the outcome. IOLs offer people who must wear glasses or contacts freedom from the hassle of these devices. With glasses, people may be restricted from participating in certain types of activities, particularly sports; IOLs may allow them to do the things they love. Additionally, many find wearing glasses uncomfortable on the bridge of the nose or tops of the ears, and many also don’t like the look of glasses. Contacts are uncomfortable and easy to lose, and some people are unable to tolerate contacts due to certain features of their eyes, and for those with very strong prescriptions, contacts may not even be possible.
Those with strong prescriptions also often are not candidates for LASIK or other laser eye procedures involving the cornea. IOLs, whether phakic or placed by RLE, are options for those people.
Phakic IOLs are the only refractive surgery procedure that is reversible, because none of the natural structures of the eye are removed or altered during their placement. If the IOL leads to undesirable side effects, doesn’t function as well as you want, or if your vision changes and the IOL is no longer the right prescription for you, then the phakic IOL can be removed and your eye will still be able to function, or it can be replaced.
The cost for per eye. This cost varies depending on several factors, including the region and the particular surgeon. You should check with the provider(s) you’re considering to determine the exact cost. Keep in mind that financing is often available. For more detail, visit our Phakic Intraocular Lens Implants (IOLs) Cost page.