Spektrum der Augenheilkunde

, Volume 27, Issue 6, pp 274–280 | Cite as

Phakic intraocular lenses: past and present

  • Elfriede Wissiak
  • Eva-Maria Lackner
  • Bertram Vidic
  • Navid ArdjomandEmail author
review article



Phakic intraocular lenses (IOLs) are gaining popularity for refractive surgeons, since these IOLs are easy to implant and can correct high ametropia up to 20 D. However, these implants can still lead to reversible and irreversible complications, even years after implantation.

Material and methods

This review gives a short overview about the different kinds of phakic IOLs, the advantages and disadvantages of these lenses and the pre- and post-operative examinations.


Most of the angle-supported phakic IOLs have been abandoned from the market few years after launching. Two anterior chamber IOLs and one posterior chamber IOL—the iris-clip IOL ‘Artisan/Verisyse’ (Ophtec, Netherlands/Abbott, USA), the angle supported IOL ‘Cachet’ (Alcon, USA) and the ‘implantable collamer lens’ (Staar, USA), are commercially available at the moment.


Phakic IOLs are a good option for the treatment of high myopia, but exact preoperative examination of the patient and consistent post-operative controls including endothelial cell count are mandatory to reduce the risk of long-term complications.


Phakic intraocular lens Myopia Hyperopia Astigmatism Endothelial cells 

Phake Intraokularlinsen – früher und heute



Phake Intraokularlinsen (IOL) gewinnen zunehmend an Popularität, da sie einfach zu implantieren sind und hohe Myopien bis zu 20 Dioptrien gut korrigieren können.

Diese Intraokularlinsen können aber noch Jahre nach der Implantation zu reversible und irreversiblen Komplikationen führen.

Material und Methodik

Diese Übersichtsarbeit soll einen kurzen Überblick über die unterschiedlichen Modelle, deren Vor- und Nachteile und die prä- und postoperativen Untersuchungen geben.


Die meisten kammerwinkelgestützten Vorderkammerlinsen wurden wenige Jahre nach deren Einführung vom Markt genommen. Zur Zeit sind zwei Vorderkammerlinsen und eine Hinterkammerlinse kommerziell erhältlich. Die irisfixierte Artisan/Verisyse IOL (Ophtec, Niederlande/AMO, USA), die kammerwinkelgestützte „Cachet“ IOL (Alcon, USA) und die „implantierbare Collamer IOL“ (Staar, USA).


Phake IOLs stellen eine gute Option zur Korrektur der hohen Myopie dar, aber genaue präoperative und regelmäßige postoperative Untersuchungen einschließlich Endothelzellmessung sind zwingend, um das Risiko langfristiger Komplikationen zu vermeiden.


Phake Intraokularlinse Myopie Hypermetropie Astigmatismus Endothelzellen 


Financial disclosure

The authors have no financial interest in any technique or product mentioned in this manuscript.

Conflict of interest

The authors declare that there are no actual or potential conflicts of interest in relation to this article.


  1. 1.
    Fujitani A, Hayasaka S, Fukuyama J, Noda S, Setogawa T. Retrocorneal ridges after anterior posterior radial keratotomy (Sato’s operation) in a patient with retinitis pigmentosa. Ann Ophthalmol. 1993;25:392–3.PubMedGoogle Scholar
  2. 2.
    Chen LJ, Chang YJ, Kuo JC, Rajagopal R, Azar DT. Metaanalysis of cataract development after phakic intraocular lens surgery. J Cataract Refract Surg. 2008;34:1181–200.PubMedCrossRefGoogle Scholar
  3. 3.
    Baikoff G. Phakic anterior chamber intraocular lenses. Int Ophthalmol Clin. 1991;31:75–86.PubMedCrossRefGoogle Scholar
  4. 4.
    Huang D, Schallhorn SC, Sugar A, et al. Phakic intraocular lens implantation for the correction of myopia: a report by the American Academy of Ophthalmology. Ophthalmology. 2009;116:2244–58.PubMedCrossRefGoogle Scholar
  5. 5.
    Fechner PU, Heijde GL van der, Worst JG. Intraocular lens for the correction of myopia of the phakic eye. Klin Monatsbl Augenheilkd. 1988;193:29–34.PubMedCrossRefGoogle Scholar
  6. 6.
    Baikoff G. Refractive phakic IOLs—then and now. Cataract & Refractive Surgery today. 2004:72–4.Google Scholar
  7. 7.
    Plainer S, Wenzl E, Saalabian AA, et al. Long-term follow-up with I-care phakic IOLs. Br J Ophthalmol. 2011;95:710–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Kohnen T, Knorz MC, Cochener B, et al. AcrySof phakic angle-supported intraocular lens for the correction of moderate-to-high myopia: one-year results of a multicenter European study. Ophthalmology. 2009;116:1314–21.PubMedCrossRefGoogle Scholar
  9. 9.
    Javaloy J, Alio JL, Iradier MT, et al. Outcomes of ZB5M angle-supported anterior chamber phakic intraocular lenses at 12 years. J Refract Surg. 2007;23:147–58.PubMedGoogle Scholar
  10. 10.
    Fellner P, Vidic B, Ramkissoon Y, et al. Pupil ovalization after phakic intraocular lens implantation is associated with sectorial iris hypoperfusion. Arch Ophthalmol. 2005;123:1061–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Espandar L, Meyer JJ, Moshirfar M. Phakic intraocular lenses. Curr Opin Ophthalmol. 2008;19:349–56.PubMedCrossRefGoogle Scholar
  12. 12.
    Sourdille P, Baikoff G, Colin J. Safety concers put spotlight on angle-supported phakic IOLs. Eurotimes. 2007 November; 8–9.Google Scholar
  13. 13.
    Kohnen T, Klaproth OK. Three-year stability of an angle-supported foldable hydrophobic acrylic phakic intraocular lens evaluated by Scheimpflug photography. J Cataract Refract Surg. 2010;36:1120–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Pechmeja J, Guinguet J, Colin J, Binder PS. Severe endothelial cell loss with anterior chamber phakic intraocular lenses. J Cataract Refract Surg. 2012;38:1288–92.PubMedCrossRefGoogle Scholar
  15. 15.
    Stulting RD, John ME, Maloney RK et al. Three-year results of Artisan/Verisyse phakic intraocular lens implantation. Results of the United States Food And Drug Administration clinical trial. Ophthalmology. 2008;115:464–72 e461.PubMedCrossRefGoogle Scholar
  16. 16.
    Dick HB, Budo C, Malecaze F, et al. Foldable Artiflex phakic intraocular lens for the correction of myopia: two-year follow-up results of a prospective European multicenter study. Ophthalmology. 2009;116:671–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Koss MJ, Cichocki M, Kohnen T. Posterior synechias following implantation of a foldable silicone iris-fixated phakic intraocular lens for the correction of myopia. J Cataract Refract Surg. 2007;33:905–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Dick HB, Buchner SE. [Toric phakic intraocular lenses]. Ophthalmologe. 2007;104:1032–40.PubMedCrossRefGoogle Scholar
  19. 19.
    Ruckhofer J, Seyeddain O, Dexl AK, Grabner G, Stoiber J. Correction of myopic astigmatism with a foldable iris-claw toric phakic intraocular lens: short-term follow-up. J Cataract Refract Surg. 2012;38:582–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Donoso R, Castillo P. Correction of high myopia with the PRL phakic intraocular lens. Journal of cataract and refractive surgery. 2006;32:1296–1300.PubMedCrossRefGoogle Scholar
  21. 21.
    Sanders DR, Doney K, Poco M. United States Food and Drug Administration clinical trial of the implantable collamer lens (ICL) for moderate to high myopia: three-year follow-up. Ophthalmology. 2004;111:1683–92.PubMedCrossRefGoogle Scholar
  22. 22.
    Choi SH, Lee MO, Chung ES, Chung TY. Comparison of the toric implantable collamer lens and bioptics for myopic astigmatism. J Refract Surg. 2010:1–7.Google Scholar
  23. 23.
    Hashem AN, El Danasoury AM, Anwar HM. Axis alignment and rotational stability after implantation of the toric implantable collamer lens for myopic astigmatism. J Refract Surg. 2009;25:S939–43.PubMedCrossRefGoogle Scholar
  24. 24.
    Sanders DR, Schneider D, Martin R, et al. Toric implantable collamer lens for moderate to high myopic astigmatism. Ophthalmology. 2007;114:54–61.PubMedCrossRefGoogle Scholar
  25. 25.
    Lee JH, You YS, Choe CM, Lee ES. Efficacy of brimonidine tartrate 0.2 % ophthalmic solution in reducing halos after laser in situ keratomileusis. J Cataract Refract Surg. 2008;34:963–7.PubMedCrossRefGoogle Scholar
  26. 26.
    McDonald JE 2nd, El-Moatassem Kotb AM, Decker BB. Effect of brimonidine tartrate ophthalmic solution 0.2 % on pupil size in normal eyes under different luminance conditions. J Cataract Refract Surg. 2001;27:560–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Ruiz-Moreno JM, Alio JL, Perez-Santonja JJ, la HF de. Retinal detachment in phakic eyes with anterior chamber intraocular lenses to correct severe myopia. Am J Ophthalmol. 1999;127:270–5.PubMedCrossRefGoogle Scholar
  28. 28.
    Ruiz-Moreno JM, Montero JA, la VC de, Alio JL, Zapater P. Retinal detachment in myopic eyes after phakic intraocular lens implantation. J Refract Surg. 2006;22:247–52.PubMedGoogle Scholar
  29. 29.
    Mastropasqua L, Toto L, Vecchiarino L, et al. AcrySof cachet phakic intraocular lens in myopic patients: visual performance, wavefront error, and lens position. J Refract Surg. 2012;28:267–74.PubMedCrossRefGoogle Scholar
  30. 30.
    Yang RB, Zhao SZ. AcrySof phakic angle-supported intraocular lens for the correction of high to extremely high myopia: one-year follow-up results. Int J Ophthalmol. 2012;5:360–5.PubMedGoogle Scholar
  31. 31.
    Ardjomand N, Kolli H, Vidic B, El-Shabrawi Y, Faulborn J. Pupillary block after phakic anterior chamber intraocular lens implantation. J Cataract Refract Surg. 2002;28:1080–1.PubMedCrossRefGoogle Scholar
  32. 32.
    Shimizu K, Kamiya K, Igarashi A, Shiratani T. Early clinical outcomes of implantation of posterior chamber phakic intraocular lens with a central hole (Hole ICL) for moderate to high myopia. Br J Ophthalmol. 2012;96:409–12.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Elfriede Wissiak
    • 1
  • Eva-Maria Lackner
    • 1
  • Bertram Vidic
    • 1
  • Navid Ardjomand
    • 1
    Email author
  1. 1.Department of OphthalmologyMedical University GrazGrazAustria

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