PHAKIC IOLS

AN EXCELLENT OPTION WHEN THE NATURAL CRYSTALLINE LENS IS STILL CLEAR

What are phakic IOLs?

A phakic IOL is an intra-ocular lens which is fixed inside the eye to correct myopia, hyperopia or astigmatism. It is an additive procedure. In contrast to lens replacement or cataract surgery we leave the natural crystalline lens inside the eye.

It is an excellent option when the natural crystalline lens is still clear and especially when the eye still has the ability to accommodate. We use the Visian ™ ICL (Intra-ocular contact lens) and also the Artiflex ™/Artisan ™ phakic IOL.

What phakic IOLs treat

Who is suitable for phakic IOLs?

Phakic IOL implantation is an excellent option for patients whose eyes are not suitable for laser eye surgery. It can provide a superior quality vision for patients who have very high prescriptions.

Whenever we perform laser eye surgery we remove a small amount of tissue from the cornea. The larger the refractive error to be corrected the more tissue has to be removed and this places limits on the amount of short and long-sightedness which can be corrected.

With phakic IOL implantation we are correcting the refractive error by placing a contact lens inside the eye. This allows us to correct almost any size of refractive error providing the eye has suitable dimensions and health to receive a lens.

As with all our treatments, it is very important that the eye is carefully assessed for its suitability to receive a phakic IOL.

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How do phakic IOLs work?

The refractive error of the eye is very carefully measured along with the dimensions of the eye. With this information, a bespoke lens is calculated for the eye and is implanted inside the eye. The Visian ICL ™ sits behind the iris just in front of the natural crystalline lens. The Artiflex ™ phakic IOL is fixed onto the front of the iris. Since this is an additive procedure the ability to focus for near with the natural lens inside the young eye is preserved. The lens can be implanted under a local anaesthetic or a general anaesthetic if preferred.

Options and alternatives

Laser eye surgery is our ‘go-to’ treatment for younger patients. However, for larger prescriptions or in patients with thinner corneas, phakic IOL implantation may be more suitable.

In older patients with signs of cataract, lens replacement cataract surgery is usually a better option.

ICL ™ (intra-ocular contact lens) implant surgery

ICL’s are small, ultra-thin contact lenses that are implanted into the eye to correct short-sightedness, long-sightedness and astigmatism. The ICL sits behind the coloured part of your eye and in front of your natural lens. Once implanted, the lens remains in your eye until you develop a cataract. Short sighted people develop cataract at a younger age – typically in their fifties.

The lens is not visible during normal social situations. If the light is shining straight into your face and someone looking at you comes very close then, they may see the lens if they have very good vision themselves.

The surgery to implant the lens usually takes about twenty minutes. It is usual to perform the surgery under a local anaesthetic with mild sedation, but we can arrange for a general anaesthetic if required.

You will be asked to use anti-inflammatory, antibiotic and topical lubricant drops for two to three months after surgery.

We ask you not to wear eye make-up for one week after surgery and to avoid tap/shower water going into the eye for one week after surgery.

No swimming for six weeks post-operatively.

Risks associated with ICL implantation

Details of the most important specific complications are given below. Each complication is listed along with how often the complication occurs eg 1 in every 100 cases performed. As you can see the complications which occur quite commonly are mild and easily treated. The complications which can cause reduced vision, are thankfully very rare:

Endophthalmitis

The risk of Endophthalmitis is 1 in 10,000. This is asevere (usually painful) infection inside the eye. Although the majority of patients with endophthalmitis can be treated successfully this complication can result in complete loss of vision in the eye.

Detached retina

A detached retina is when the seeing layer of cells inside the eye come away from the wall of the eye (this can occur in eyes that have not had any surgery and is much more common in short-sighted people). ICL implantation surgery may increase the risk of retinal detachment although this remains unproven. Retinal detachment can be successfully treated with an operation in the majority of cases.

Refractive surprise

A refractive surprise is an unexpectedly large (or different from expected) need for glasses. 1 in 50 patients is at risk of a refractive outcome greater than one diopter from the target. This can be corrected with laser eye surgery in the majority of cases.

Cystoid macular oedema

The risk of cystoid macular oedema is 1 in 1000. This is inflammatory fluid in the centre of the retina. This causes blurring of the central vision. It is usually mild and needs no treatment. Rarely it can be severe and require prolonged treatment in order to restore sharpness of vision.

Suprachoroidal haemorrhage

The risk of suprachoroidal haemorrhage is less than 1 in 5000. This is bleeding inside the eye which may require the operation to be completed on another day and even more rarely may cause reduced vision.

Corneal decompensation

The risk of corneal decompensation is less than 1 in 1000. This is clouding of the normally clear front window of the eye. This only occurs in patients with an abnormal lining of the cornea. This can be treated by replacement of the lining of the cornea.

Dislocation of the lens implant (IOL)

Dislocation of the lens implant (IOL) happens in less than 1 in 1000 cases. This is movement out of position of the lens implant. This may require the original lens implant to be replaced.

Post-operative raised intraocular pressure

The risk of post-operative raised intraocular pressure is 1 in 50. This is raised pressure in the eye that may require temporary treatment but will not affect the final outcome.

Post-operative inflammation

The risk of post-operative inflammation is 1 in 20. This may need an increased number of eye drops after the operation to bring this under control but will not affect the final outcome.

Allergy

The risk of llergy is less than 1 in 100. Allergic reactions can arise to drops given after the operation, causing an itchy swollen eye until the drops are stopped or changed.

Other issues sometimes arising from ICL implantation

Cataract formation

ICL implantation may cause the natural lens inside your eye to become cloudy at a younger age than it would have done otherwise. The cloudy natural lens is called a cataract and causes reduced vision. This is easily treated and at the time of cataract surgery the ICL would also be removed.

Dry eye symptoms

Symptoms of irritation in the eyes, redness and/or temporary blurring are very common in people who have not had any kind of eye surgery. Most commonly this is due to dryness of the surface of the eyes. Tear production decreases as we get older. In addition, modern life (staring at iPads with the central heating on) causes increased evaporation of moisture from the front of the eye. ICL implant surgery causes a temporary increase in dryness symptoms. It takes between 3 and 6 months for the dryness symptoms to return to whatever level is normal for that patient. Often patients continue with the simple measures we recommend to improve the tear film and improve the comfort of their eyes long-term.

Glare/Halo effects

In dim light conditions such as when driving at night, the pupils dilate. This can result in light from car headlights catching the edge of the lens implant and entering the pupil. This may result in some increased glare or halo effect around car headlights when driving at night. This usually decreases with time after treatment but rarely can persist.

Light sensitivity

Rarely, some patients experience increased light sensitivity following ICL implant surgery. This symptom improves over the months following treatment. Very rarely it can be persistent.

Results at a glance

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Laser procedures

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Cataract procedures

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Better than the national average of complication rates

My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.

Patricia Walton

Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution. Thanks to the treatment, I feel rejuvenated, independent and much younger!

John Hazelgrave

Many thanks for all your care and kindness. To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.

Grace C.

May I offer grateful thanks for your expertise in operating on my eyes. It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.

Jean D.

You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers - all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.

John

DISCOVER YOUR EYE TREATMENT OPTIONS

GIVE US A CALL ON: 0345 6430 466
OR REQUEST A CALL BACK

REQUEST A CALL BACK

Artifex ™ lens implant surgery

Artiflex ™ lenses are small, ultra-thin contact lenses that are implanted into the eye to correct short-sightedness, long-sightedness and/or astigmatism. An Artiflex ™ lens is attached to the iris with two tiny clips. Once implanted, the lens remains in your eye until you develop a cataract. Short sighted people develop cataract at a younger age – typically in their fifties.

The lens is not visible during normal social situations. If light is shining straight into your face and someone looking at you comes very close then they may see the lens if they have very good vision themselves.

The surgery to implant the lens usually takes about twenty minutes. It is usual to perform the surgery under a local anaesthetic but we can arrange for a general anaesthetic if required.

You will be asked to use anti-inflammatory, antibiotic and topical lubricant drops for two to three months after surgery.

We ask you not to wear eye make-up for one week after surgery and to avoid tap/shower water going into the eye for one week after surgery. We will also ask you not to swim for six weeks post-operatively.

What are the risks of Artiflex implantation surgery?

Details of the most important specific complications are given below. Each complication is listed along with how often the complication occurs in about 1 in every 100 cases performed. As you can see the complications which occur quite commonly are mild and easily treated. The complications which can cause reduced vision, are thankfully very rare:

Endophthalmitis

The risk of endophthalmitis 1 in 10,000. Endophthalmitis is a severe (and usually painful) infection inside the eye. Although the majority of patients with endophthalmitis can be treated successfully this complication can result in complete loss of vision in the eye.

Detached retina

The seeing layer of cells inside the eye come away from the wall of the eye. (this can occur in eyes that have not had any surgery and is much more common in short-sighted people). Artiflex ™ implantation surgery may increase the risk of retinal detachment although this remains unproven. Retinal detachment can be successfully treated with an operation in the majority of cases.

Refractive surprise

Refractive surprise is an unexpectedly large (or different from expected) need for glasses after surgery. 1 in 50 patients have a refractive outcome greater than one diopter from the target. This can be corrected with laser eye surgery.

Cystoid macular oedema

The risk of cystoid macular oedema is 1 in 1000. Cystoid macular oedema is inflammatory fluid in the centre of the retina. This causes blurring of the central vision. This is usually mild and needs no treatment. Rarely it can be severe and require prolonged treatment in order to restore sharpness of vision.

Suprachoroidal haemorrhage

The likelihood of a suprachoroidal haemorrhage is less than 1 in 5000. A suprachoroidal haemorrhage is bleeding inside the eye which may require the operation to be completed on another day and even more rarely may cause reduced vision.

Corneal decompensation

The risk of corneal decompensation is less than 1 in 1000. Corneal decompensation is clouding of the normally clear front window of the eye. This only occurs in patients with an abnormal lining of the cornea. This can be treated by replacement of the lining of the cornea. The health of the lining of your cornea will need to be checked on an annual basis after Artiflex lens implantation. These visits are covered by the surgical fees.

Dislocation of the lens implant (IOL)

The risk of a dislocation of the lens implant (IOL) is less than 1 in 1000. A dislocation of the lens implant (IOL) is a movement out of position of the lens implant. This may require the original lens implant to be replaced.

Post-operative raised intraocular pressure

The risk of post-operative raised intraocular pressure is 1 in 50. Post-operative raised intraocular pressure is raised pressure in the eye. This may require temporary treatment but will not affect the final outcome.

Post-operative inflammation

The risk of post-operative inflammation is 1 in 20. This may need an increased number of eye drops after the operation to bring this under control but will not affect the final outcome.

Allergic reaction

The risk of an allergic reaction is less than 1 in 100. Allergic reactions may occur in response to drops given after the operation, causing an itchy swollen eye until the drops are stopped or changed.

Issues related to Artiflex ™ lens implantation

Cataract formation

Artiflex ™ lens implantation may cause the natural lens inside your eye to become cloudy at a younger age than it would have done otherwise. The cloudy natural lens is called a cataract and causes reduced vision. This is easily treated and at the time of cataract surgery the Artiflex ™ lens would also be removed.

Dry eye symptoms

Symptoms of irritation in the eyes, redness and/or temporary blurring are very common in people who have not had any kind of eye surgery. Most commonly this is due to dryness of the surface of the eyes. Tear production decreases as we get older. In addition modern life (staring at iPads with the central heating on) causes increased evaporation of moisture from the front of the eye. Artiflex ™ implant surgery cause a temporary increase in dryness symptoms. It takes between 3 and 6 months for the dryness symptoms to return to whatever level is normal for that patient. Often patients continue with the simple measures we recommend to improve the tear film and improve the comfort of their eyes long-term.

Glare/Halo effects

In dim light conditions such as when driving at night, the pupils dilate. This can result in light from car headlights catching the edge of the lens implant and entering the pupil. This may result in some increased glare or halo effect around car headlights when driving at night. This usually decreases with time after treatment but rarely can persist.

Light sensitivity

Rarely, some patients experience increased light sensitivity following Artiflex ™ implant surgery. This symptom improves over the months following treatment. Very rarely it can be persistent.

Request a Call Back

The best way to figure out your treatment options is to request a call back by filling in the form below:

Request a callback

My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.

Patricia Walton

Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution. Thanks to the treatment, I feel rejuvenated, independent and much younger!

John Hazelgrave

My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers – all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.

John

Laser eye surgery has changed my life. Now, having had laser, I wake up in the morning and I can see and it’s unbelievable.

Claire Varley

Laser eye surgery has greatly improved my quality of life. I’ve been able to discard my glasses after thirty years!

Arthur Brown

If you are thinking of having Laser Eye Surgery, try these guys – they really are the best in their field.

Mr CE Poulter

I felt I was treated as an individual and all my questions were answered. From my experiences – I can highly recommend Mr Ball.

Janet Howden

Wonderful, Wonderful, Wonderful! I am so grateful to you and your team. Thank you very much indeed.

Dorothy S.

Thank you for your skilled interventions which have given me my sight back.

Doreen G.

To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.

Grace C.

Thank you very much for the treatment you gave me – I can see so well now, and reading has once again become a real pleasure.

Charles S.

It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.

Jean D.

You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

I had LASIK on both eyes at Custom Vision Clinics, and can now see better than 20/20, without my glasses or contact lenses. More importantly, I now feel that I can get more out of my busy life.

Karen

At the consultation, Mr Ball found that I had early cataracts. Following cataract surgery at Custom Vision Clinics, I am almost completely independent from glasses.

Anne