Phakic anterior chamber intraocular lenses

The risk-benefit ratio associated with phakic anterior chamber IOL implantation demonstrates that these lenses are an acceptable alternative to other means of refractive correction for high ammetropia. Although it is a more invasive method than other refractive techniques, implantation of these lenses provides a better image quality, and their short-term predictability, safety, stability, and efficacy have been demonstrated in different studies. Development of phakic anterior chamber IOLs is rapidly evolving. Foldable lenses for insertion through small incisions already are being evaluated in clinical trials. Changes in design features are constantly being made in order to address issues such as endothelial contact or pupil ovalization. The predictability of the refractive outcome may be increased by improvements in power calculation of the lenses, which depends on the refraction of the patient. A method more accurate than the white-to-white distance is also required for determining the lens's overall diameter. Adequate IOL sizing will help to reduce the incidence of complications such as pupil ovalization due to oversized lenses. Continued monitoring of patients implanted with phakic anterior chamber IOLs is needed to confirm the long-term adequacy of such implants as a generalized refractive surgical procedure.