Implantable Contact Lenses (Phakic IOLs)

Implantable contact lenses, technically known as phakic IOLs, allow people to experience correction of nearsightedness (myopia) without the use of glasses or contacts. They are an excellent option for people who are not eligible for, or do not choose to have, LASIK or other refractive surgeries. These lenses do not replace the natural lens the way that other intraocular lenses do. Instead, these are "helper" lenses that work much like glasses or contacts to correct your nearsightedness.

But unlike glasses or contacts, they do not need daily maintenance and cannot get lost, scratched, or broken. You cannot feel the implantable contact lens, nor can you see it, but you will see the results.

In approval studies, 92-95% of patients had 20/40 or better vision after receiving implantable contact lenses. And a three-year retrospective of both brands of implantable contact lens approved by the FDA showed that more than 84% of people receiving the implantable contact lenses had uncorrected visual acuity of 20/40 or better. This means that the overwhelming majority of people who receive implantable contact lenses had what is considered normal vision and could drive without glasses.

There are currently two FDA-approved implantable contact lenses: Verisyse™ and Visian ICL®. According to a small comparative study, Visian seems to give slightly better results, with 100% of patients seeing 20/30 or better, compared to 89% achieving 20/30 or better with Verisyse.

How Implantable Contact Lenses Work

Myopia is the result of a slight dysfunction in how the eye works. To receive a clear image of an object, the light from that object must be focused precisely on the retina. However, in people with myopia, the cornea is too steep and focuses light rays from distant objects in front of the retina. LASIK and other refractive surgeries correct this by changing the shape of the cornea. Glasses and contacts correct the focus of the cornea by bending light rays slightly before they get to the cornea, so when the cornea focuses them, they focus directly on the retina.

Implantable contact lenses work in a similar way, but they are implanted between your cornea and your eye's lens. The Verisyse phakic IOL is inserted outside the iris, and is actually attached to the iris. The Visian ICL is placed behind the iris. Results are typically immediate.

Risks of Implantable Contact Lenses

As a precaution, the FDA warns of the possibility of severe vision loss from implantable contact lenses.

The main documented risk for the Verisyse is retinal detachment, which is about 10 times more likely following implantation for people with more severe nearsightedness, maybe as much as 5%. Surgical reintervention was necessary for about 4% of patients, and 2.6% of patients received LASIK or other refractive surgery in addition to implantable contact lenses to achieve optimal vision correction.

Visian's main documented risks were a loss of vision of two or more lines in 2% of patients. Retinal detachment had a similar risk as for Verisyse. Surgical reintervention was also about the same as for Verisyse, but about 3.9 % of patients in the clinical trials received LASIK or other refractive surgery to achieve best results.

Implantable contact lenses may allow you to be free of glasses or contacts, and they present a good alternative to refractive surgeries. To decide whether they might be right for you, schedule an implantable contact lens consultation with a local doctor to discuss risks and benefits.