In this article, I will give you, a brief summary of often clinical used phakic anterior chamber intraocular lenses (PAC IOL) types and their advantages and disadvantages.

  • PAC IOL Vs. LASIK

PAC IOL

disadvatages:

postoperative astigmatism

refractive error caused by increments in length of the eyes

exact calculation of  lens diopter

endothelium risk

infection

Advatages:

reversibility or adjustability

the preservation of accommodation

LASIK

disadvatages:

cornel ablated

small effective optical zones

the predictability and stability of the procedure

halos and glare

unreversibility or unadjustability

infection

Advatages:

the preservation of accommodation

less effection to intraocular system

  • Classification
    • Angle-Fixated

Strampelli was the first surgeon (in 1953) to implant this. The older products were ZB implant (Domilens Corp., Lyon, France) , ZB 5M (Domilens) and The Nuvita MA 20 (Bausch & Lomb, Claremont, CA) by Baikoff lens. The representative product was Phakic 6 (Ophthalmic Innovations International, Ontario, CA). Model ZSAL-4 (Morcher, Stuttgart, Germany) was similiar to ZB5M. The first foldable, phakic, angle-fixated anterior chamber IOL is the Vivarte lens, manufactured by Ioltech (La Rochelle, France) and distributed by CibaVision (Duluth, Ga) which could be insert to the eye by a 2mm incision. But this kind of lens have flexible haptics. Sometimes will cause problems. :(

    • Iris-Fixated

    Worst and Fechner’s phakic iris-claw lens is manufactured
    and distributed by Ophtec (Gro¨ningen, Netherlands), under the name of Artisan. Do you know the first design of iris fixated lens was by worst? It is heard that the artisan is renamed to verisyse, am I right?

  • PAC IOL Complications
    • Corneal Endothelial Cell Loss
    • Pupil Ovalization
    • Retinal detachment (RD)
    • Subclinical chronic inflammation
    • Glare and halo effects

It is a sad trend that more and more doctors gives up the Angle-Fixated lens because it will damage the cornel’s function. Many papers proved that. The iris claw type seems good for patients. The ICL will cause cataract and secondary glaucoma, but incidence is very low.