Transcript Phakic IOL - AUGENKLINIK

Phakic IOL
How the eye works
• Light rays enter the eye through
the clear cornea, pupil and lens.
• These light rays are focused
directly onto the retina, the lightsensitive tissue lining the back of
the eye.
• The retina converts light rays into
impulses, sent through the optic
nerve to your brain, where they
are recognized as images.
• 70% of the eye's focusing power
comes from the cornea and 30%
from the lens.
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Refractive errors
• Inability to see clearly is often caused by refractive error.
• Four types of refractive error:
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Myopia (nearsightedness)
Hyperopia (farsightedness)
Astigmatism
Presbyopia
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Refractive errors: myopia
• In myopia (nearsightedness),
there is too much optical
power in the eye
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The distance between the
cornea and the retina may be
too long or the power of the
cornea and the lens may be too
strong.
• Light rays focus in front of
the retina instead of on it.
• Close objects will look clear,
but distant objects will
appear blurred.
Myopia, or nearsightedness
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Refractive errors: hyperopia
• In hyperopia (farsightedness),
there is too little optical power.
• The distance between the
cornea and the retina may be
too short.
• Light rays are focused behind
the retina instead of on it.
Hyperopia, or farsightedness
• In adults (but not children),
distant objects will look clear,
but close objects will appear
blurred.
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Refractive errors: astigmatism
• In astigmatism, the cornea is
curved unevenly—shaped more
like a football than a basketball.
• Light passing through the
uneven cornea is focused in
two or more locations.
• Distant and close objects may
appear blurry.
Astigmatism occurs when light
passes through football-shaped
cornea and/or lens
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Refractive errors: presbyopia
• Presbyopia is an age-related condition
in which your eyes gradually lose the
ability to see things up close, because
the lens of the aging eye can no longer
change shape.
• When we are young, the lens in our
eyes is flexible and is able to change
focus easily between near and far
objects, like an autofocus on a camera.
• At around age 40, this flexibility begins
to gradually decrease, making it more
difficult to see objects up close, unless
the eye has nearsightedness.
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What is refractive surgery?
• A group of outpatient surgical procedures used to alter how your
eye focuses light rays on the retina, thereby improving vision and
reducing dependence on glasses and contact lenses.
• In most cases, refractive surgery affects the shape of your cornea
to redirect how light is focused onto the retina. Popular
procedures include LASIK, LASEK, PRK and CK.
Refractive
surgery
procedure on
the cornea
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What is refractive surgery?
• Most refractive surgery is performed on the cornea and affects
only the front of your eye, while the rest of your eye will change
naturally as you age.
• In some cases, refractive surgery procedures don’t reshape the
cornea; instead, the eye’s natural lens is either replaced or
enhanced by an implantable lens that helps correct vision.
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What is a phakic intraocular lens (IOL)?
• The word “phakic” describes the state of
the eye that still has its natural (crystalline)
lens intact.
• A phakic IOL, sometimes known as an
implantable contact lens (or ICL), is used
to treat high degrees of nearsightedness
(myopia).
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Studies are ongoing to evaluate the treatment
of farsightedness (hyperopia) and astigmatism
with the phakic IOL as well.
• The eye’s natural lens is not removed, so
patients can retain their pre-existing ability
to focus.
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Two types of phakic IOLs
How is the phakic IOL procedure performed?
• Performed in a surgical suite.
• A light sedation is usually offered for anxiety.
• Entire procedure usually takes 10 to 20 minutes.
• Anesthetic eyedrops are instilled prior to surgery.
• A laser peripheral iridotomy (LPI) is performed prior to surgery to
ensure normal fluid flow inside the eye following phakic IOL
insertion.
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How is the phakic IOL procedure performed?
• The procedure is performed
using one of two methods:
Method 1
• One or more small incisions are
made at the junction of the
sclera (white part of the eye)
and the cornea.
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How is the phakic IOL procedure performed?
• The phakic IOL is inserted onto the iris (the colored part of the eye).
The customized IOL is inserted through
the incision
The IOL is gently placed into its
proper position
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How is the phakic IOL procedure performed?
• The incision is repositioned with fine sutures.
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Sutures are finer than a human hair.
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How is the phakic IOL procedure performed?
The IOL firmly in place
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How is the phakic IOL procedure performed?
Method 2
• One or more small incisions are made at the junction of the sclera
(white part of the eye) and the cornea.
• The phakic IOL is inserted beneath the iris (the colored part of the
eye).
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How is the phakic IOL procedure performed?
Phakic IOL injected into the eye beneath the iris using an injector
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How is the phakic IOL procedure performed?
Phakic IOL rests beneath the iris and above the natural lens of the eye
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How is the phakic IOL procedure performed?
Phakic IOL in the eye (in front of the iris)
Phakic IOL in the eye (behind the iris)
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How is the phakic IOL procedure performed?
• Once the lens is properly
positioned inside the eye, it
provides the necessary
correction to redirect light
rays precisely onto the retina.
• Steroid and antibiotic
eyedrops will need to be
applied for about one week
following the surgery as your
vision continues to improve.
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Considerations for the phakic IOL procedure
• May be recommended for patients with corneas too thin to safely
perform corneal refractive surgery (e.g., LASIK, PRK).
• May be recommended for patients with high degrees of refractive
error or significantly dry eyes.
• May result in less visual distortion (aberrations), such as glare and
halos, than corneal refractive surgery for a given refractive error.
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Considerations against the phakic IOL procedure
• In some cases, there is not enough room in the eye to accommodate the
lens.
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Your ophthalmologist (Eye M.D.) will take careful measurements to ensure adequate
space in the eye to allow safe placement of the phakic IOL.
• Once the lens is inside the eye, repositioning or removal of the IOL may be
required if the lens is at risk of damaging any intraocular structure.
• Presence of cataract.
• History of retinal detachment or other serious retinal disease.
• History of ocular inflammation.
• History of glaucoma.
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Risks and possible side effects of phakic IOL surgery
• Over-correction or under-correction (with a possible need for a retreatment).
• Because the phakic IOL comes into contact with the delicate structures
inside the eye, infection or inflammation may result after the IOL is
implanted.
• Haze and halo effect at night.
• Excessive tearing.
• Potential for increased intraocular pressure (IOP).
• Potential for retinal detachment.
• Cataract formation and corneal swelling (infrequent).
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Is phakic IOL surgery right for you?
• Advanced surgical procedures, including phakic IOL, are creating
more opportunities for people who want to be less dependent on
glasses or contacts.
• Refractive surgery may not totally eliminate your need for
corrective lenses. Glasses/contacts may still be needed for
activities such as fine or detailed work, reading and perhaps night
driving.
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Is refractive surgery right for you?
• A large part of the success of any refractive surgery depends on
your understanding of the procedure and your expectations.
• Since refractive surgery is an elective procedure, you have the
opportunity and responsibility to become fully informed about its
risks and benefits.
• Your ophthalmologist will explain the specific technique, its
benefits, as well as possible risks and/or side effects associated
with your particular case.
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Discuss options and questions with
your ophthalmologist
• With the help of your ophthalmologist, it’s ultimately your
responsibility to weigh the risks and side effects of a procedure
with the benefits it has to offer.
• If you decide refractive surgery is right for you, you may join
millions of people who have reduced their dependence on glasses
or contacts.
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