Phakic Lenses

Surgically implanted lenses, known as phakic intraocular lenses, or PIOL, are a further option for the treatment of visual impairments such as myopia, hyperopia and astigmatism. This technique is particularly indicated for those cases where it is not possible to perform a laser correction and the refractive error is too high (myopia > 10 dioptres, hyperopia > 5 dioptres) or in case the cornea is too thin or irregular. Surgery with intraocular lens is more invasive than laser surgery, but in case of strong defects, it allows strong correction and better visual quality than the latter.

What is the use of IOL installations
Intraocular lenses (IOL), which are similar to contact lenses, are defined as phakic lenses insofar as they are implanted inside the eye where the crystalline lens was not removed and can be placed in front of the iris (anterior chamber) or behind, between the iris and
crystalline (posterior chamber). The purpose of these lenses is to divert light rays in such a way that these focus exactly on the retina. Unlike glasses which produce this effect from the outside or a laser operation in the corneal level, phakic IOLs act from the inside of the eye, nearer to the optical system, and can correct myopia until 15 or more dioptres. Phakic Lens installation is a quick operation. The little lens made of soft and flexible material is inserted inside the eye through a little cut that does not need any suture. This operation of substituting the transparent crystalline lens to correct a visual impairment is technically the same operation that we perform in case of the extraction of a cataract, except that in the latter case the crystalline lens is not transparent but opaque, and the role of the intervention is mainly to erase opaqueness and then to correct the visual impairment. The operation is suggested particularly when it concerns just one eye (while the other is normal) or when there is a significant difference between one eye’s defect and the other, since the operation is useful to erase or reduce the visual imbalance caused by this difference.

What are the advantages of IOL technique?

• Reversibility: unlike what happens with the laser, the structures of the eye and of the cornea are not modified. In case of need, it is possible at any moment to pull out the lens from the eye, restoring the preoperative status.
• Rapidly implemented: the surgery lasts about 15 minutes and is performed in the
  clinic.
• Topical Anaesthesia: anaesthetic eye drops.
• Painless surgery
• Rapid visual results: the day after surgery the vision is already on the way to recovery. This is going to stabilize permanently in a short time and remains steady over the years.
• Excellent predictability of the result even in high defects: if the refractive correction should not be completed it is possible to refine it with little tweaks with the laser.
• High visual quality of the operated patients: 90% of the cases obtain a 100% sight
  without any tweaks correction after; 10% of the other cases obtain an 80% – 90% sight without corrections and to obtain a 100% sight they still need one little
  correction that goes from 0.25 to 0.75 dioptres.

What to do before the surgery with IOL installations
There are no specific instructions, but it is recommended to follow some tips in order to have an easier and successful operation:

• Wash your hair the night before surgery because in the post-operation it is not
  recommended to wash your face or even bend over for some time.
• Foresee comfy clothes, possibly with buttons so you do not have to put your newly
  operated eye at risk.
• Foresee to have already some ready meal for the days after surgery to keep the eye
  away from heat or steam sources.
• Follow the medication prescribed by your surgeon.

What to do after the surgery with IOL installations

• Wear dark sunglasses that can protect the eye from external factors (rain, wind, dust, etc.) even for the first day after surgery at home and for the first two weeks outside.
• Sleep with protective shields to avoid rubbing the eye for the first few days.
• Do not bend or lift weights for 15 days to avoid increasing intraocular pressure and compromise the healing process.
• Do not rub or press the newly operated eye.
• Use the eye drops and the eye cream prescribed by the eye surgeon for 15 days.
• Do eye check-ups the day after surgery, 15 days later, one month later, and one year later.

How much time is needed for the patient to return to everyday life with an IOL implant?
The patient will have blurry vision for 2-3 days. The eye may seem sensitive to the light and to touch, but the recovery is fast and everyday activities can restart two weeks after the operation. In the first few days recovery may be difficult if the operation has been complicated. During the recovery period you can watch TV, read and work at the computer. These activities cannot damage the operated eye. In most cases after this operation, over 90% of people regain 80% of the visual acuity. If there are some pathological states of the retina, visual acuity can be worse.

Am I eligible for IOL plant?
Preconditions for the IOL lens implant foresee:

• Age between 20 and 45 years.
• Intolerance to contact lenses and glasses.
• Good structural conditions of the eye (absence of ocular pathologies or anomalies).
• Steady myopia or prone to minor progression.
• Steady prescription of glasses or contact lenses for one year at least.

The IOL technique is contraindicated in case of cataract at an early stage, past eye inflammations, corneal endothelial problems, glaucoma, medical history of retina detachment, ocular diabetes damage, any significant eye pathology and those who rub their eyes. The suitability for the operation must be verified by the eye surgeon, expert in refractive surgery, after an accurate eye examination, which includes the essential exams to completely evaluate the eye.