Phakic intraocular lenses have the advantage of treating a much larger range of refractive errors than can be treated safely and effectively with corneal refractive surgery. The skills required for insertion are, with a few exceptions, similar to those used in cataract surgery. The equipment needed for IOL implantation is substantially less expensive than an excimer laser and is similar to that used for cataract surgery. In addition, the PIOL is removable; therefore, the refractive effect should theoretically be reversible. However, any intervening change caused by the PIOL implantation is often permanent. Compared with refractive lens exchange (discussed later in this chapter), PIOL implantation has the advantage of preserving natural accommodation; it also has a lower risk of endophthalmitis and postoperative retinal detachment because the crystalline lens barrier is preserved and there is minimal vitreous destabilization.
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.