What are phakic IOLs and what conditions do they treat?

Phakic IOLs are lens implants similar to contact lenses that we place inside the eye, and they’re used to correct the glasses prescription in patients, typically patients who have very high levels of glasses prescriptions.

So the most common type of phakic IOL is called an implantable collamer lens, or an ICL. There have been many generations of these phakic IOLs, but really, the most sophisticated and the best current type of implantable lens or phakic IOL is called the ICL or implantable collamer lens. This is made out of a very sophisticated polymer material, and it’s completely unique.

This polymer is a mixture of protein and plastic, and it’s completely unique in medicine. What this lens does is it’s inserted into the eye through a tiny little incision, a keyhole incision, and only when it goes into the eye does it expand and adopt its full shape. So it’s capable of being squashed or folded into a very tiny, narrow diameter, inserted through a tiny keyhole, and it will expand in the eye to form the correct shape to correct your glasses prescription.

Then it needs to be manipulated just to sit in the correct position, and the correct position is actually quite deep in the eye. It’s on the surface of the natural lens of the eye. So this is a form of a contact lens which sits inside your eye on the surface of your natural lens. It’s placed there in a ten-minute procedure under local anesthesia and can stay there for many, many years until the lens of the eye develops a cataract, which is typically in a patient’s 60s, 70s, or 80s.

Now, what we expect after inserting an implantable collamer lens or a phakic IOL is that within 24-28 hours of surgery, the patient’s vision should be sharp, and their vision should be as good as it was – sometimes better than it was – with glasses. The vision then should stay stable for years and years.

Very occasionally, patients’ prescriptions can change as the eye ages, and it’s possible to fine-tune the vision with a small amount of laser eye surgery in these patients. The lens will stay in place, sometimes for the patient’s entire life, until they pass away, but very often, with patients living older and older, what’s happening is patients are now developing cataracts in their 60s, 70s, 80s.  And when a patient develops a cataract, they’ll notice that their vision starts to become misty.

What we do is we can simply remove the phakic IOL or the ICL lens implant – it’s extremely easy to remove – and then proceed with standard cataract surgery. The vision correction of the ICL can then be factored into the cataract operation, and there’s no need to place another ICL or phakic IOL in the eye at the time of the cataract surgery. We simply remove the existing one and perform standard cataract surgery.