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Implanted Lenses May Treat Milder Nearsightedness

Study: Phakic Intraocular Lenses Are as Safe and Effective as Standard Laser Eye Surgery
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Phakic IOLs: Risk of Cataracts continued...

“Our findings suggest phakic IOLs are safer than excimer laser surgery" for correcting moderate to high levels of nearsightedness, Barsam says. “Although it’s not currently standard clinical practice, it could be worth considering phakic IOL treatment over the more common laser surgery" for patients with moderate nearsightedness.

Regarding the risk of cataracts, Barsam says more long-term studies are needed to assess any risks that might not arise during a one-year follow up and that might be unique to phakic IOL patients.

Second Opinion

James Salz, MD, clinical professor of ophthalmology at the University of Southern California at Los Angeles and a spokesman for the American Academy of Ophthalmology, says the data reviewed in this report are too limited to draw any immediate conclusions that would change current practices.

“It’s a bit misleading with a small review like that because it’s just a few hundred cases,” Salz tells WebMD. “Most of us would not agree it’s safer to do an intraocular lens procedure because it’s a more invasive procedure. Laser surgery doesn’t cause cataracts in anybody, but phakic IOLs cause cataracts in a percentage of people. I don’t think that study would change the opinion of most surgeons who would do this surgery on a daily basis.”

Salz says phakic IOLs might be an option for moderate myopia in patients with abnormal-shaped corneas, but he says “those cases are rare.”

D. Rex Hamilton, MD, director of the Laser Refractive Center at the Jules Stein Eye Institute at the University of California at Los Angeles, says the findings in this review reflect his own clinical experiences.

“The findings of this study are consistent with my clinical experience that LASIK is extremely safe and effective up to moderate levels of myopia (-7 to -8 D),” Hamilton tells WebMD in an email interview. “Above this range, LASIK patients tend to lose some contrast sensitivity (the ability to see shades of grey) particularly in dim light settings. Phakic IOLs have an advantage with regard to contrast sensitivity in the highly myopic population. Although there is a slightly increased risk of cataract formation with phakic IOL implantation (particularly in higher corrections, above -15 D and in patients over the age of 40 at the time of implantation), phakic IOL implantation remains the procedure of choice for highly myopic patients who qualify.”

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