What is Phakic IOL?

Phakic IOLs are transparent implantable lenses that are inserted between the cornea and the iris (the colored portion of your eye) or just behind the iris, with the natural lens in place. Phakic lenses provide a clearer vision without glasses or contact lenses

What are the advantages of Phakic IOL implantation?

  • Patients will not need glasses or contact lenses for life.
  • It improves the quality of vision drastically and establish a high definition vision.
  • The phakic IOL surgery corrects a stigmatism.
  • It is intended to be permanent; however, it can be reserved if needed.

How to prepare for Phakic IOL surgery?

The doctor will perform a pre-surgical examination to ensure that the patient is suitable for a phakic IOL implantation surgery. The pre-surgical examination involves taking a detailed medical history of the patient and performing thorough examinations on the eyes including measurements of the pupil, the distance between the cornea and iris (anterior chamber depth), and the number of cells on the back of the cornea (endothelial cell counts). Complying with the doctor’s prescription and instructions before surgery is crucial. Here is a summary of precautions that will be advised by the doctor:

1- Avoid contact lenses

Patients should avoid wearing contact lenses for a few weeks before both the pre-surgical examination and the surgery itself, owing to the fact that contact lenses function by changing the shape of the cornea causing inaccurate measurements during the pre-surgical examination and inaccurate results after surgery.

2- The doctor might recommend a laser iridotomy

Laser iridotomy is an in-office procedure that involves making a small hole in the extreme outer edge of the iris (the colored part of the eye). This procedure is strongly recommended to prevent fluid accumulation which will increase the pressure of the eye after phakic lens implantation surgery. It is done in a few minutes. However, the patient needs to wait for some time for the doctor to check the eye pressure and prescribe steroid drops to reduce inflammation from the iridotomy procedure.

3- Some medications should be avoided before surgery

For instance, there are medications that increase bleeding during surgery and will need to be avoided for some time before surgery. The time during which these medications should be avoided varies according to the specific medication and what it treats. Other medications however are continued before surgery to prevent certain complications such as blood clotting or a stroke.

4- Follow prescription antibiotic drops and/or anti-inflammatory drops

Days before surgery, the doctor will prescribe antibiotic drops and/or anti-inflammatory drops. Complying with these medications is very important to prevent both infection and inflammation during and after surgery.

5- Patients should arrange for a ride to the surgery, back home afterwards, and to the follow-up
appointment the day after surgery.

Keeping in mind that driving is prohibited after phakic implantation surgery, an arrangement of transportation will be required. The patient can resume driving after a time that is decided by the doctor.

6- Patients are advised to not eat or drink anything after midnight.

According to FDA recommendations, patients should not eat the night before surgery.

What happens during Phakic IOL surgery?

Phakic IOL implantation surgery involves only one incision in the cornea to insert the lens. It is done in 30 minutes or so during which the patient is not put to sleep; instead local anesthetics are used so the patient does not feel any pain, only a slight pressure in the eye

The steps for this surgery are:

1. Injecting anesthetics around the eye to ensure that the patient does not feel any pain during surgery. Another injection is also needed to prevent eye movement during surgery.

2. The surgeon also makes sure that the patient’s eyes are kept open using a mechanical device called a lid speculum.

3. An incision is then made in the cornea, sclera or limbus.

4. Afterwards, the surgeon applies a lubricant to protect the back of the cornea during lens insertion.

5. A phakic IOL lens is then inserted behind cornea and in front of the iris

6. The surgeon adjusts the position of the phakic IOL lens and removes the lubricant.

7. He closes the incision with tiny stitches.

8. Finally, the surgeon applies eye drops or ointment and covers the eye with a patch and/or a shield.

 

How to make the most out of the surgery?

For the first several days after surgery, patients might experience hazy or blurry vision. This symptom usually subsides by time; however it may fluctuate for 2 to 4 weeks before vision stabilizes. Other symptoms might evolve such as sensitivity to light, glare, or halos around lamp posts, or redness in the eye. The patient might also experience an uncomfortable feeling in the eye (feeling that something is in the eye). Fortunately, all post-surgery symptoms decrease upon recovery over a few weeks. There are certain precautions that help the patient recover faster and achieve desired results after surgery.
The patient is advised to:

1.Follow the doctor’s prescription of post-surgery medications which often include antibiotic eye drops and antiinflammatory eye drops for several weeks after surgery to prevent infection and/or inflammation. Also, pain medications are usually prescribed to make the patient more comfortable during the first few days after the surgery.

2.Visit the doctor the day after surgery. During this visit, the doctor will remove the patch and/or shield to check the patient’s vision and eye condition.

3.Continue wearing the shield all day and all night or just at night according to the doctor’s instructions. The shield protects the eye from impact and pressure from surrounding environment.

 

4. Do not rub the eyes, especially for the first few days after surgery.

5.Contact the doctor immediately if post-surgical symptoms deteriorate rather than improve.

6.Wash hands before putting the prescribed eye drops.

7.Do not get water in the eyes for a time as advised by the doctor.

8. Avoid bending from the waist to lift objects from the floor to prevent pressuring the eyes.

9. Avoid any strenuous activity until the doctor allows it (usually after 8 weeks of healing).

If you are ready for a high definition vision, Phakic IOL implantation surgery is your option to consider. Book a consultation now with Dr. Ramy Riad.

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