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Phakic Intraocular Lenses (PIL)

Phakic intraocular lenses are permanent implants into the eye without removing the eye's natural lens.

The FDA has approved Phakic intraocular lenses only for Myopia or nearsightedness. This procedure is performed to replace a person's glasses or contact lenses.

Why Phakic and not LASIK?

While both can treat Myopia, LASIK can't treat extreme cases of Myopia; Phakic intraocular lenses can.

Conditions for Phakic Intraocular Lenses Candidacy

Candidacy for Phakic Intraocular lenses is similar to LASIK with a few exceptions:

People who participate in sports with a high risk of eye trauma (boxing, baseball, basketball, etc.), would not be considered a good candidate for this procedure. Your eye could be more susceptible to rupture or retinal detachment. The lens could also dislocate.

If you have only one good eye, you would not be considered a good candidate for this procedure. You and your eye care professional should discuss the risk of implanting a Phakic intraocular lens in the good eye before moving forward with the procedure.

If you have a large pupil, an abnormal iris or a shallow anterior chamber - any one of these issues could disqualify you as a candidate.

Phakic Intraocular Lens – Pre-op

Much of the pre-op will determine whether you are a good candidate. This will entail an eye examination, measurement of your pupils and anterior chamber depth, and an endothelial cell count. Your eye care professional will also want to know your medical history as well.

You'll also have a procedure called a Laser Iridotomy. This can be done in the doctor's office and should take only a few minutes. What happens here is the doctor will give you drops to numb your eye and to make the pupil smaller. Using a laser, he will make a few small holes on the outer edge of your iris which prevents fluid buildup and pressure in the back chamber of your eye.

You should arrange for transportation home after the surgery and for the first follow-up visit.

Phakic Intraocular Lenses – The Procedure

Generally, patients, aren't put to sleep for Phakic Intraocular lens surgery, but you may be given a mild sedative to help you relax. Your eye will be made numb either by injection or drops; the surrounding area will be cleaned and your eyelids immobilized.

The doctor will then make a tiny incision in your cornea, sclera or limbus. They will place lubricant in the incision to protect the back of the cornea and then insert the Phakic lens. Depending on the type of Phakic lens, the doctor will either position it in front or behind the iris.

The doctor will remove any lubricant then stitch up the incision. Your eye will be covered with a shield or patch and you'll be brought to recovery to rest for a few hours.

The Phakic intraocular procedure should take approximately 30 minutes. Before you leave, you'll be given an implant ID card.

Phakic Intraocular Lenses – Post-op

After the procedure, there may be mild discomfort and feel like something is in your eye. Unless there is severe pain you shouldn't be concerned. Expect your vision to be blurry for a few days; it can fluctuate for several weeks before stabilizing. Eye drops will be prescribed, and you'll be given a shield to wear at night.

Because this is a permanent fix, and because there haven't been studies on long-term risks, expect to maintain a regular set of visits with your eye care professional. Yearly eye exams are the norm, but any unusual issues with your eyes should be reported immediately.

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