Posterior chamber phakic lens implants can effectively treat a large degree of myopia while retaining the accommodation of a youthful crystalline lens and without altering the corneal power or shape. In this case, the phakic IOL served this patient well for 10 years but over time, an anterior cataract developed.
At the pre-op consultation, the IOL calculations were performed in the manner typical for a highly myopic eye. Since the phakic IOL is optically transparent, it does not affect the axial length measurement with optical coherence biometry.
During surgery, we first explant the phakic IOL with care taken to avoid damaging the anterior lens capsule. Because the phakic IOL is thin and flexible, we can easily remove it through a standard 2.75 mm phaco incision. The rest of the surgery proceeds normally, and in this case we place a toric IOL in the capsular bag to address the astigmatism.
Click below to learn how to explant a phakic IOL and then perform cataract surgery: