Intracorneal Lens Implantation(ICI)

Phakic intraocular lenses (PIOLs)

Lenses that are implanted into the eye to correct vision without taking out the natural lens are call phakic intraocular lenses (PIOLs). PIOLs are made of clear synthetic plastic. They sit either just in front of, or just behind, the pupil – a bit like building your contact lenses into your eyes.

PIOL implantation is effective in treating high spectacle prescriptions, and is widely used to treat younger patients who are not suitable for laser eye surgery. The commonest type of PIOL implanted worldwide is the Visian ICL (intraocular collamer lens). This is a soft flexible implant designed to sit just behind the pupil and in front of the natural lens in the eye. You cannot see or feel ICLs after implantation, and you do not need to clean them.

The other main type of PIOL is the Artisan/Verysise PIOL. This PIOL clips onto the iris just in front of the pupil, and is sometimes visible as a glint in the eye. Like ICLs, you cannot feel Artisan/Verysise PIOLs after implantation, and you do not need to clean them. If you are suitable for PIOL implantation, your surgeon will discuss which type is the best option for you

What are the benefits?

PIOLs are highly effective at treating both high glasses prescriptions and astigmatism. For most patients, vision after PIOL surgery is similar to vision in contact lenses before surgery without the discomfort and limitations on activity.

Glasses may still be required for some activities after treatment, particularly reading in older patients, but these will be a low prescription and relatively inexpensive.

Short sight and astigmatism normally stabilize in the late teens or early 20s, but natural prescription changes can occur at any stage in life. So laser vision correction is sometimes needed to enhance distance vision in the years after PIOL implantation.

Although PIOL implantation is often bracketed with cosmetic surgery procedures, the benefits are mainly functional. It is designed to make you less dependent on glasses and contact lenses, helping you to lead an active lifestyle more easily.

Who is suitable for PIOL implantation?

Young patients who are unsuitable for laser vision correction are often offered PIOL implantation. This is because PIOLs can correct a wider range of spectacle prescriptions than laser vision correction, and may be a safer option if you have pre-existing cornea or eye surface problems.

You need to be over 20 years of age and have a stable spectacle prescription. This is normally defined as no change greater than 0.5 units (0.5D) in the last 2 years. The range of spectacle prescriptions that can be treated effectively is approximately:

• Up to -17.00D of myopia or short sight
• Up to +10.00D of hyperopia or long sight
• Up to ±4.50D of astigmatism

 You may not be suitable for PIOL implantation if you have other problems with your eye health including cataracts, glaucoma, or recurrent inflammation in the eye (uveitis). You also need to have enough room in the front of the eye to fit the PIOL safely. This is normally determined by a scan of the eye at your initial consultation.

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