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Speaker outlines characteristics of ideal phakic IOL

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NEW ORLEANS — A presenter here at Refractive Surgery Subspecialty Day outlined his criteria for the ideal phakic IOL and discussed a particular implantable Collamer lens that satisfies them.

The symposium was co-sponsored by the American Academy of Ophthalmology and the International Society of Refractive Surgery.

The ideal phakic IOL, according to Alaa El-Danasoury, MD, should have predictability, stability, biocompatibility, preservation of quality of vision, fast recovery, and easy removal or exchange.

Alaa El-Danasoury

The Visian ICL V4c (STAAR Surgical) meets these criteria, El-Danasoury said.

This lens is particularly biocompatible, he said.

“If you insert a phakic IOL into the eye, the intraocular tissue is prone to damage,” El-Danasoury said. “Anterior subcapsular cataract after ICL is less than 0.5% in my hands.

“Another improvement in the last few years is that the ICL allows better aqueous outflow,” he said, eliminating the need for laser iridotomy and surgical iridectomy.

Lens rotation is always a concern with toric lenses, El-Danasoury said.

“I compared patients with spheric vs. toric IOLs, and patients with the toric ICL are doing much better than those with a spherical IOL,” he said. “And more than 50% that I implant are torics.”

All phakic IOLs have excellent predictability in correcting myopia, El-Danasoury said, and the Visian ICL and toric ICL are highly predictable, between –18 D and +12 D.

Posterior chamber IOLs provide better functional vision due to the large optical zone, he added.

The ICL is also easy to remove or exchange, he said.

“The majority of these patients will have these lenses removed 20 years from now because they will have cataracts, and the ICL is very easy to remove,” El-Danasoury said.

“Visian ICL is my preferred phakic IOL,” he said. “It meets all of my criteria better than any others. But can the best get better?
“Already we have the V4c on the market, the preloaded V5 is coming soon, and there will be a multifocal in the future,” he said.

Disclosure: El-Danasoury is a consultant to Nidek and STAAR Surgical.