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Implantable Lenses: Help for Severe Myopia

Implantable Lens Pros and Cons continued...

The Visian lens is foldable, so it can be inserted through a smaller incision that usually requires no sutures. But because it sits close to the natural lens of the eye, it can cause cataracts in a small percentage of people, says James J. Salz, MD, clinical professor of Ophthalmology at the University of Southern California. "And we don't know how many patients will get a cataract if they've had that lens in their eye for over 10 years." The Visian lens has been modified recently to decrease the risk of cataracts.

Also, as with any surgery, both implantable lenses pose a small risk of infection, which in rare cases could cause blindness.

In clinical trials, both brands corrected vision well. With the Visian lens, 95% of patients had 20/40 or better vision, the level needed to obtain a driver's license, and 59% had 20/20 or better after three years. With the Verisyse lens, 92% had 20/40 or better vision, and 44% had 20/20 or better after three years.

What's Involved in Phakic IOL Surgery

Phakic surgery is an elective procedure, so it's not covered by insurance. It costs $3,500 to $5,500 per eye. Surgeons operate on just one eye at a time, so you need to have it twice to correct vision in both eyes.

"The lens is expensive and the procedure is more involved and intensive than LASIK," says Hamilton.

The surgery itself takes about 10 to 15 minutes, he says. "We use topical numbing drops and IV sedation, and you can see out of the eye immediately. There's no need to patch the eye shut."

"The recovery time is essentially overnight," Hamilton tells WebMD. "The next day a patient's vision is excellent." In comparison, it can take up to six months for vision to stabilize after LASIK surgery.

Should You Have Implantable Lenses or LASIK?

"A big question is: who are the candidates for these lenses?" says Salz. "Because you're putting the lens inside the eye, it's a different set of risks than LASIK surgery, which is done on the cornea outside the eye."

Implantable lenses are a good choice for people who are extremely nearsighted, says Salz. "Patients who are above -10 diopters or -11 diopters often can't get enough correction with a LASIK procedure." 

"These patients…have to wear contact lenses every waking hour because they can't see otherwise, or they have to wear super-thick glasses, which most people find unacceptable," Hamilton says. With implantable lenses, "you really change their lives."

For people who have nearsightedness of -8 diopters to -11 diopters, Salz says the choice isn't so clear. Some surgeons prefer to use phakic lenses, while others prefer LASIK, he says. If you fall into that group, it's important to ask your ophthalmologist to explain the benefits and risks of each surgery. You might also consider getting a second opinion.

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