What are Phakic IOLs?
Phakic intraocular lens implants, or phakic IOLs (often simply referred to as IOLs), are lenses that are surgically implanted into the eye, either behind or in front of the iris (the colored part of the eye). The term “phakic” refers to the fact that these lenses are placed in front of your natural lenses, which are not removed. This can correct problems in the vision such as nearsightedness, farsightedness, or astigmatism, which are too severe to correct with corneal laser procedures such as LASIK. IOLs are sometimes referred to as implantable contact lenses (ICLs). Many people no longer need glasses or contact lenses after having IOLs placed.
If you’re choosing refractive surgery, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that phakic IOLs are right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of phakic IOLs at Phakic Intraocular Lens Implants (IOLs): Risks and Benefits.
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 doctor who will perform your procedure if you decide to proceed.
How it’s done
You will be reclining in a surgical chair during the procedure. You will receive several drops of numbing medication in your eye. Next, an eyelid holder will be placed that prevents you from blinking during the procedure.
An incision is made in the cornea. Next, the IOL is placed. If the IOL will be placed in front of the iris, eyedrops are given that cause the pupil to constrict and be very small. The IOL is placed, and is attached to the iris.
If the IOL will be placed behind the iris, eyedrops are given that cause the pupil to dilate and be very large. The IOL is placed through the pupil; once behind the iris, it will unfold, and usually does not need to be secured in place.
Once the IOL is in place, the corneal incision is sutured closed with tiny dissolvable sutures. An eye shield is then placed over the eye to protect it.
Preparing for the procedure
Choosing your clinic
When choosing an eye surgeon for your refractive surgery, you want a highly-trained professional with experience in this type of surgery. A fellow of the American College of Surgeons has received training in surgery (look for the acronym FACS), and a member of the American Board of Ophthalmology has training and experience specifically in the surgical and nonsurgical care of eye diseases. Also, choose a surgeon with whom you feel comfortable and safe, and who listens to you and tries to understand your goals. If you have friends who’ve had refractive surgery, and you like their results, ask for a referral. While cost may be a consideration, don’t allow this to override more important factors in your decision. Your safety and the quality of your results are worth a little extra spending.
For more help in your search for a refractive surgeon, visit our How to Find the Refractive Surgeon page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for the procedure
For at least a few weeks before your refractive surgery, you’ll need to stop wearing contact lenses and switch to glasses. Contact lenses can distort your corneas by pressing on them, which could lead to inaccurate measurements, meaning that the outcome of your surgery won’t be ideal.
Also, in order to minimize the amount of debris that’s in your eye during your surgery, you should skip using any eye creams or makeup the day before and the day of your surgery. Otherwise, there could be buildup in your eye, leading to inaccuracies during your procedure.
Your surgeon will perform an iridotomy before your procedure. In an iridotomy, small incisions are made at the edge of the iris; this allows fluid to circulate more freely within the eye, which reduces the risk that there will be a rise in eye pressure after the IOLs are placed. In many cases, your surgeon will have you come in for this about two weeks before your IOL procedure, although some surgeons perform the iridotomy at the same time as the phakic IOL placement.
After the procedure, you’ll need a family member or trusted friend to drive you home. You should plan to spend the rest of the day resting.
You will be given a transparent eye shield to wear over the treated eye(s). The shield is intended to remind you not to touch or bump your eyes, as any touching of the eye could damage the cornea and cause it to heal incorrectly. You will need to wear the shield full time for two days, and then should wear it at least at night for several more days, though wearing it during the day may provide extra safety for your eye. You will also be given eyedrops, which you will need to use several times a day; the drops keep your cornea moist as it heals, and help to prevent infection and inflammation.
It will take three to six months for healing of your eye(s) to occur. At this point, your vision will stabilize, and the side effects from the healing will resolve. You will then know whether you will need an enhancement, which is a second vision correction surgery designed to provide minor corrections and bring the vision closer to ideal.