IOL type determines complications in phakic surgery

September 11, 2007

The type of phakic IOL chosen strongly governs the type of complication that is likely to occur in the long-term. Posterior, angle-supported anterior and iris supported anterior phakic IOLs all have different issues that face the surgeon.

The type of phakic IOL chosen strongly governs the type of complication that is likely to occur in the long-term. Posterior, angle-supported anterior and iris supported anterior phakic IOLs all have different issues that face the surgeon.

"I'm not going to deal with in surgery complications because that's specifically to do with surgical technique, which we all need to work on constantly, " said Dr Antonio Marinho. "I'm not going to focus on those complications, but on the long-term issues that are IOL-related. "

For angle-supported phakic IOLs, for example, Dr Marinho notes that most complications relate to sizing and rotation, decentration or pupil distortion.

Complications of iris-supported phakic IOLs include pigment deposits in a few cases and, exceptionally, a mild uveitis, due to excessive manipulation during surgery. "In this surgery, decentration and luxation are signs of poor surgical technique, " Dr. Marinho noted.

Posterior-chamber phakic IOLs have long been associated with the development of cataract because of their close proximity to the natural lens, he told the audience.

"With a short IOL, you get a small vault, with a danger of cataract. With a long IOL, you get excessive vault, with a danger of pigment dispersion glaucoma. With the PRL, there might be a risk of migration into the vitreous, " he said.

There are many potential complications with phakic IOLs but good surgical technique and careful biometry can avoid most of them, he concluded.