Publication Exclusive: Phakic IOLs may make cataract surgery more challenging

For extremely nearsighted patients who are seeking independence from glasses and contact lenses, implantation of a phakic IOL can be a reasonable choice. In the U.S., we have access to two different types of phakic IOLs: anterior chamber iris-clip phakic IOLs and posterior chamber sulcus-fixated phakic IOLs. Both of these options can correct extreme degrees of myopia, as much as –20 D, and they are both designed to stay inside the eye for many years. At some point, however, when a cataract develops, the phakic IOL will need to be explanted at the same time as the cataract surgery. Then a single in-the-bag pseudophakic IOL can be implanted to address the refractive state of the eye. This is more complicated than a standard cataract surgery, and care must be taken at every step in order to achieve the best visual outcome.