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Vision Problems Guide

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Permanent Contact Lenses

By Linda Fugate PhD
 
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Vision correction has come a long way since the original hard contact lenses that gained popularity 40 years ago. Phakic intraocular lenses are the equivalent of permanent contact lenses, although the manufacturers do not use the term “contact”. These lenses are surgically implanted in the eye. They are similar to the lenses used to replace the natural lens in cataract surgery, but the natural lens is left in place when a phakic lens is implanted.

Phakic lenses are an alternative to LASIK surgery (laser in situ keratomileusis) for patients who are highly nearsighted. LASIK surgery works well for patients who need relatively small corrections to the refractive power of the cornea, which provides about two thirds of the total light refraction in the eye. By removing part of its tissue, LASIK reshapes the cornea and changes the focal length. But the cornea is very thin. There's a limited amount of material that can be removed. For highly nearsighted eyes, the best corrected visual acuity that LASIK can provide may not be acceptable to the patient. In addition, removing relatively large amounts of corneal tissue may increase the potential for night glare and corneal ectasia, which is an abnormal curvature that interferes with vision.

There are several categories of phakic intraocular lenses:
1. Angle-supported anterior chamber lenses. I have not found any of these commercially available.
2. Posterior chamber lenses. According to Reference 2, there are five lens designs available and almost 35,000 implants completed.
3. Iris-fixated lenses. According to Reference 1, this is the most promising type. The Artisan Phakic IOL was approved by the FDA in 2004. Reference 3 reports that 150,000 have already been implanted.

Reference 1 reports a five-year study of the Artisan Phakic Lens in 26 eyes from 15 patients. The authors conclude that implantation of this lens is effective and generally safe. However, loss of endothelial cells was significant enough for the authors to note: “We recommend caution in contemplating implantation of these phakic IOLs in young patients or those with compromised endothelial cell counts”.

Add a Comment3 Comments

Michele Blacksberg RN HERWriter

I know some people are corrected with one eye being the nearsighted eye and the other the farsighted one but I don't think I could tolerate that. Sounds like progress is coming. I may just need to be more patient. Thanks for checking!

May 31, 2010 - 6:07pm
Linda Fugate PhD

There are some multifocal options used for cataract patients, who have the natural lenses replaced by plastic lenses. Also some patients get "monovision" correction, with one eye corrected for near vision and the other for distance vision. Research is in progress for an "accomodative" plastic lens that attaches to the eye muscles and changes focal length. See http://www.empowher.com/eyes-vision/content/presbyopia-decline-vision-mi...

May 31, 2010 - 5:57pm
Michele Blacksberg RN HERWriter

Hi LInda, thanks for the update on lens. I am very near sighted but did not want to consider Lasik surgery because it is so permanent.
One of the problems I am experiencing as I age is that I am also becoming farsighted as well. I wear weak reading glasses with my contacts to read. I recently tried bifocal contacts which I can see very well with but they dry out my eyes more than regular contacts. Do you know if these new implanted lens help with the nearsighted/farsighted problem?
thanks,
Michele

May 31, 2010 - 5:37pm
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