Phakic intraocular lens insertion is an intraocular procedure, with all the potential risks associated with intraocular surgery. In addition, each PIOL style has its own set of associated risks. Lenses currently available in the United States with PMMA optics are not foldable, so their insertion requires a relatively large wound, which may result in postoperative astigmatism. Posterior chamber PIOLs have a higher incidence of cataract formation. For patients with PIOLs in whom a visually significant cataract eventually develops, the PIOL will have to be explanted at the time of cataract surgery, possibly through a larger-than-usual wound. Although PIOLs to correct hyperopia are available outside the United States, indications for their implantation are narrower because the anterior chamber tends to be shallower than in patients with myopia, causing the IOL to sit too close to the corneal endothelium and resulting in increased endothelial cell loss.
Table 8-1 Phakic Intraocular Lenses
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.