Phakic IOLs: A photo finish?

Phakic IOLs must be fixated in an eye with less space compared to pseudophakic IOLs, attributable to the presence of the crystalline lens.4 The crystalline lens itself is particularly sensitive to injury, whether traumatic or inflammatory.5 Corneal endothelial cells are in close proximity, and the i...

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Bibliographic Details
Published in:American journal of ophthalmology 2004-11, Vol.138 (5), p.849-851
Main Author: Steinert, Roger F.
Format: Article
Language:English
Subjects:
Anterior Chamber - surgery
Cataracts
Ciliary Body - surgery
Contact lenses
Eye surgery
Humans
Iris - surgery
Lasers
Lens Implantation, Intraocular - methods
Lens, Crystalline - physiology
Lenses, Intraocular
Myopia
Myopia - surgery
Optics
Regulatory approval
Studies
Surgery
Suture Techniques
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Summary:Phakic IOLs must be fixated in an eye with less space compared to pseudophakic IOLs, attributable to the presence of the crystalline lens.4 The crystalline lens itself is particularly sensitive to injury, whether traumatic or inflammatory.5 Corneal endothelial cells are in close proximity, and the iris is both fragile and highly reactive.6 Patients who are candidates for a phakic IOL are considerably younger on the average than cataract surgical patients; phakic IOLs are going to need to be in place for many decades without adverse effects on any of these structures.7 In sum, the bar is high. [...]while the iris-fixated IOL showed no problems in this study, other concerns such as the potential for inflammation,16 progressive endothelial cell loss, cataract formation, and the challenge of surgical implantation are issues to be addressed by studies with other methodologies.17,18 Despite pressures on refractive surgeons from eager patients to implant pseudophakic IOLs to solve the optical problems of high myopia, the study by Baumeister and coworkers reported this month shines a bright yellow caution light.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2004.09.054