What Are the Risks?
Implanting a phakic lens involves a surgical procedure. As in any other
medical procedure, there are risks involved. That's why it is important
for you to understand the limitations and potential risks of phakic
intraocular lens implant surgery.
Before undergoing surgery for implantation of a phakic intraocular lens,
you should carefully weigh the risks and benefits and try to avoid being
influenced by other people encouraging you to do it. Risks
- You may lose vision. Some patients lose vision as a result
of phakic lens implant surgery that cannot be corrected with glasses,
contact lenses, or another surgery. The amount of vision loss may be
severe.
- You may develop debilitating visual symptoms. Some patients
develop glare, halos, double vision, and/or decreased vision in situations
of low level lighting that can cause difficulty with performing tasks,
such as driving, particularly at night or under foggy conditions.
- You may need additional eye surgery to reposition, replace or remove
the phakic lens implant. These surgeries may be necessary for your
safety or to improve your visual function. If the lens power is not
right, then a phakic lens exchange may be needed. You may also have
to have the lens repositioned, removed, or replaced, if the lens does
not stay in the right place, is not the right size, and/or causes debilitating
visual symptoms. Every additional surgical procedure has its own risks.
- You may be under treated or over treated. A significant proportion
of treated patients do not achieve 20/20 vision after surgery. The power
of the implanted phakic lens may be too strong or too weak. This is
because of the difficulties with determining exactly what power lens
you need. This means that you will probably still need glasses or contact
lenses to perform at least some tasks. For example, you may need glasses
for reading, even if you did not need them before surgery. This also
means that you may need a second surgery to replace the lens with another,
if the power of the originally implanted lens was too far from what
you needed.
- You may develop increased intraocular pressure. You may experience
increased pressure inside the eye after surgery, which may require surgery
or medication to control. You may need long-term treatment with glaucoma
medications. If the pressure is too high for too long, you may lose
vision.
- Your cornea may become cloudy. The endothelial cells of your
cornea are a thin layer of cells responsible for pumping fluid out of
the cornea to keep it clear. If the endothelial cells become too few
in number, the endothelial cell pump will fail and the cornea will become
cloudy, resulting in loss of vision. You start with a certain number
of cells at birth, and this number continuously decreases as you age,
since these cells are not replenished. Normally, you die from old age
before the number of endothelial cells becomes so low that your cornea
becomes cloudy. Some lens designs have shown that their implantation
causes endothelial cells to be lost at a faster rate than normal. If
the number of endothelial cells drops too low and your cornea becomes
cloudy, you will lose vision and you may require a corneal transplant
in order to see more clearly.
- You may develop a cataract. You may get a cataract, clouding
of the natural lens. The amount of time for a cataract to develop can
vary greatly. If the cataract develops and progresses enough to significantly
decrease your vision, you may require cataract surgery during which
both the natural and the phakic lenses will have to be removed.
- You may develop a retinal detachment. The retina is the tissue
that lines the inside of the back of your eyeball. It contains the light-sensing
cells that collect and send images to your brain, much like the film
in a camera. The risk of the retina becoming detached from the back
of the eye increases after intraocular surgery. It is not known at this
time by how much your risk of retinal detachment will increase as a
result of phakic intraocular lens implantation surgery.
- You may experience infection, bleeding, or severe inflammation
(pain, redness, and decreased vision). These are rare complications
that can sometimes lead to permanent loss of vision or loss of the eye.
- Long-term data is not available. Phakic lenses are a new technology
and have only recently been approved by the FDA. Therefore, there may
be other risks to having phakic lenses implanted that we don't yet know
about.
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