Are Phakic IOLs Preferable to LASIK for Myopia?

Myopia is on the rise. By 2050, nearly half of the world’s population is expected to be myopic, said Erik L. Mertens, MD, FRACOphth, speaking during Refractive Surgery Subspecialty Day. Although refractive surgery is a viable choice for patients with myopia, phakic intraocular lenses (IOLs) may prove to be a better option for many of these patients, he said.

Advantages. Phakic IOLs have a high benefit-to-risk ratio as well as a long history of use, Dr. Mertens said. Additional advantages include the following:

• Tissue preservation. Because the cornea is not reshaped for refractive effect, corneal tissue is preserved.
• Treatment of moderate to high myopia. Phakic IOLs can correct very high levels of myopia and have been found to outperform LASIK correction in these cases.
• Quality of life. Phakic IOLs provide excellent quality of vision with no induced higher-order aberrations.

What’s available. In the United States, the FDA has approved the Verisyse IOL, an anterior chamber lens, and the Visian implantable collamer lens (ICL), a posterior chamber lens. The Toric Visian IOL is also available for correction of astigmatism.

Cautions. Given the long track record of phakic IOLs, there is considerable information on safety. Thus, patient selection becomes paramount. “It’s very important to look at the product information [for each IOL] for indications, warnings, and precautions,” Dr. Mertens noted.—Jean Shaw

Financial disclosures. Capsulaser: C,O; Medicem: C,O; Ophtec: L; Rayner Intraocular Lenses: C; Staar Surgical: C; TearLab: L.

Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.

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