Phakic Intraocular Lens (pIOL) in the Treatment of High Myopia

Phakic intraocular lenses (pIOL) can be an effective surgical intervention for the correction of high myopia. Current FDA approved pIOLs include the Verisyse iris-fixated anterior chamber pIOL, and the Visian posterior chamber implantable collamer lenses (ICLs) by Staar Surgical. Specific inclusion and exclusion criteria should be evaluated for proper patient selection, including age, stability and degree of refractive error, anatomical measures, and presence of ocular comorbidities. Preoperative testing involves various imaging modalities such as ultrasound biomicroscopy (UBM), corneal topography, and lens biometry. Lens sizing can be determined using established nomograms. Visual and refractive outcomes show good safety and efficacy with pIOLs compared with keratorefractive surgery. Potential risks and complications include induction of higher-order aberrations (HOA), endothelial cell loss, cataract development, and retinal complications.