In recent years, significant progress has been made in correcting refractive defects, one of the most common consultations in ophthalmology. Together with laser-based refractive surgery techniques, phakic intraocular lens (PIOL) implantation is one of the solutions growing in popularity to treat this type of eye problem; it can eliminate or minimise refractive errors such as myopia, hyperopia or astigmatism, without altering the internal structure of the eye. The specialists from the Institute of Ocular Microsurgery (IMO) highlight the advantages of this type of surgery because it can be performed “quickly and comfortably for the patient, and, above all, it does not depend on the thickness or curvature of the cornea”.
A technique in constant evolution
Dr Daniel Elies, specialist from the IMO’s Department of Cornea, Cataract and Refractive Surgery, and pioneer in ICL implantation in Spain (having performed over 3,000 procedures), emphasises that this type of surgery can improve the quality of life of those who suffer from poor vision due to objects being out of focus and who want to dispense with optical correction (glasses or contact lenses). “It can correct some 18 dioptres of myopia and 12 dioptres of hyperopia, depending on the space that is available within each person’s eye,” he explains. The procedure involves implanting a phakic lens between the cornea and the crystalline lens through a small incision in the eye (of less than 3 mm), without affecting any of the intraocular structures.
At the moment, phakic intraocular lenses are continually evolving: new models have increased the range of dioptres that can be corrected (more than by laser techniques) and the manufacture of new designs means that an iridectomy (partial puncture of the iris) is no longer necessary. Likewise, the specialists are working on further developments that, in the future, will allow this type of lens to correct problems such as presbyopia and eye strain. Currently, as with cataracts, it is only possible to correct these problems using pseudophakic lenses, which do replace the crystalline lens.
Reversible and comfortable for the patient
One of the great advantages of ICLs is that the procedure is reversible and that it can be undone at any time if there is a significant change in prescription or another need arises. “If, in the future, the patient has other health problems that affect the eye, such as diabetes or hypertension, it is possible to remove the lens and start again,” adds Elies. Because it does not involve removing the crystalline lens, this type of refractive surgery is particularly indicated for young people (between 18 and 45 years old), and particularly those who want to correct high prescriptions of myopia, hyperopia or astigmatism. Patients see an improvement in the quality of their vision after a short procedure that does not usually result in a complicated post-operative period. Although many people believe that lens implantation is more complicated that laser surgery, “after the procedure, they often tell us that it was not particularly painful or uncomfortable. Furthermore, their return to normal life, such as work or playing sports, is usually very quick. They are surprised to find out that after a few days their vision is sharper and that after a week they can lead a perfectly normal life,” adds Elies.
Nonetheless, the specialists at the IMO recommend that an ophthalmology assessment is performed to evaluate the most appropriate diagnosis and treatment based on each person’s visual defect. Laser-based refractive surgery techniques (such as PRK, LASIK, LASEK and EPI-LASIK) are also available and therefore they recommend that a personalised evaluation is performed. Ultimately, the ophthalmologists will indicate the most appropriate procedure based on the state of the cornea and the eye in general, as well as the dioptres of each patient.