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Wednesday, August 23, 2006

Use Your New Lens to Read the Fine Print
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Options abound for those with above average amounts of nearsightedness (myopia) or farsightedness (hyperopia).

First, there are eyeglasses (remember them?)

Contact lenses: daily disposable, weekly disposable, daily care, extended wear, etc.

Refractive surgery: Radial keratotomy, PRK, AK, LASIK, LASEK

Adjustable explants: INTACS

Clear lens extraction with a calculated intraocular lens (IOL) substitution: Take a corrected 20/20 eye and with some luck make it, er, 20/20!

The newest treatment is IOL implantation without removing the natural lens. Think of it as a piggyback lens providing the missing refractive correction. Phakic is an adjective meaning 'the patient still has the natural lens in the eye' so these are called Phakic IOLs. This device can be placed either in front of the colored iris (photo) or between the iris and the natural lens. Careful! Any physical contact between the phakic IOL and the natural lens will lead to cataract formation (and MORE surgery!)


Delicate intraocular surgery is required in order to implant the phakic IOL. That means a trip to the operating room, sterile procedures, microinstrumentation, and a surgical incision. Sutures are required to close the incision. Anytime there is an incision there is always a risk of infection and postoperative astigmatism (excessive corneal curvature).


Phakic IOLs may be a good choice for selected patients. Today's models will not correct near vision so folks over 40 should expect to buy some bifocals afterwards. Hey myopes! Remember, even though your eye's optics may no longer need those minus lenses your eyeball is still myopic. That means the increased risk of developing peripheral retinal holes and (possible) retinal detachments persists. After phakic IOL implantation you will still need periodic exams of your stretched retina.

It's better that you know all of the proposed benefits and potential risks before deciding to have an elective intraocular surgical procedure. Make sure your surgeon answers all of your questions before giving your consent to any surgery.

Related Topics: Update on Contact Lens Eye Infection, WebMD Video: Focus on DSAEK Eye Surgery

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Posted by: Dr. Lloyd at 1:48 AM

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