الفهرس | Only 14 pages are availabe for public view |
Abstract The development of phakic IOLs has been one of trial and error throughout the past century. Despite multiple disappointing complications and due to the perseverance of admirable surgeons, they have become a promising alternative for the treatment of high degrees of myopia and hyperopia available today. The high myope and hyperope are often poor candidates for corneal laser vision correcting surgery. On the other hand, with proper patient selection and counseling, these same patients may do extremely well with phakic IOLs. Although the use of phakic IOLs is certainly very exciting for the correction of high refractive error, the lack of long-term results continues to remain a concern. The later long-term studies are promising with regard to stabilization of endothelial cell loss. However, this will continue to remain a concern simply due to the lack of ability for the corneal endothelium to regenerate. A more accurate reproducible method for determining ciliary sulcus size is needed. Refinements in the techniques should allow continued improvements in safety and efficacy. The CIBA Vision PRL is proving itself a safe and effective alternative to laser vision correction. It is especially beneficial for patients with high spherical refractive errors or those who are not suitable candidates for keratorefractive procedures. Surgeons familiar with techniques of cataract extraction and posterior chamber lens implantation will find most techniques associated with implantation of this lens familiar. The fact that the lens floats in the posterior chamber makes it easier to size and will possibly lead to less cases of IOLinduced lens opacification than other posterior chamber phakic IOLs. However, this aspect of the lens will hinder the likelihood that a toric version of this lens will be developed. The Phakic 6H2 lens has a design that may reduce the complications that have plagued previous myopic phakic IOLs. Phakic anterior chamber lens designs have been successively modified, leading to the development of the Phakic 6H2 design. The results to date are promising, but further long-term studies are needed to ensure the safety and efficacy in the moderate to high myopic population. The use of phakic IOLs in pseudophakic patients may be a safe and effective alternative in the management of pseudophakic anisometropia. This technique may offer the advantage of a minimally invasive and reversible procedure. It may also be useful in introducing multifocal optics into the pseudophakic eye for correction of presbyopia. Only reports using the ICL are presently available. Similar success may be obtained with the use of other phakic intraocular lenses. |