Phakic intraocular lenses

Purpose of review Recent advances in the design and material of phakic intraocular lenses have made them very predictable, safe and effective. The use of these lenses in refractive surgery is expected to increase very significantly in the near future. The aim of this review is to update the reader regarding the recent advances reported on this topic during 2007. Recent findings Several new studies demonstrate the superior visual outcomes of phakic intraocular lenses over other refractive surgeries in patients with moderate and high myopia, with or without astigmatism, especially in the areas of visual quality and contrast sensitivity. In addition, other studies have reviewed the long-term complications of different designs of phakic intraocular lenses, such as endothelial cell loss, cataract formation and the risks of retinal detachment and choroidal neovascularization. New anterior segment imaging and measurement technologies such as very high frequency ultrasound, optical coherence tomography and Scheimpflug imaging provide valuable information about anterior segment anatomy and may allow custom-designed phakic intraocular lenses with proper sizing. Summary Long-term concerns with endothelial cell loss and cataract formation remain. Proper sizing and positioning are important and possible with new imaging modalities. Improved design, safety, predictability and visual quality of phakic intraocular lenses make them invaluable for the correction of severe ametropias.