eMedicine Specialties > Ophthalmology > Refractive Disorders

Myopia, Phakic IOL: Multimedia

Author: Arun Verma, MD, Senior Consultant, Department of Ophthalmology, Dr Daljit Singh Eye Hospital, India
Coauthor(s): Daljit Singh, MBBS, MS, DSc, Professor Emeritis, Department of Ophthalmology, Guru Nanak Dev University, Amritsar, India; Director, Daljit Singh Eye Hospital
Contributor Information and Disclosures

Updated: May 16, 2008

Multimedia

Phakic myopia lens of -20.0 diopters, 7 years pos...
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Media file 1: Phakic myopia lens of -20.0 diopters, 7 years postoperatively, in a 30-year-old man. There is slight upward decentration. The lens appears well tolerated.
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Phakic myopia lens of -20.0 diopters, 7 years pos...

Phakic myopia lens of -20.0 diopters, 7 years postoperatively, in a 30-year-old man. There is slight upward decentration. The lens appears well tolerated.

The drawing shows the relation of the phakic iris...
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Media file 2: The drawing shows the relation of the phakic iris claw lens to the surrounding structures. Courtesy of Professor Jan J. F. Worst, MD.
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The drawing shows the relation of the phakic iris...

The drawing shows the relation of the phakic iris claw lens to the surrounding structures. Courtesy of Professor Jan J. F. Worst, MD.

Slit lamp photograph of optical section of the an...
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Media file 3: Slit lamp photograph of optical section of the anterior segment showing a gap between the anterior surface of the crystalline lens and the posterior surface of the implanted myopia iris claw lens. Courtesy of Professor Jan J. F. Worst, MD.
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Slit lamp photograph of optical section of the an...

Slit lamp photograph of optical section of the anterior segment showing a gap between the anterior surface of the crystalline lens and the posterior surface of the implanted myopia iris claw lens. Courtesy of Professor Jan J. F. Worst, MD.

Phakic minus iris claw lens, 12 years postoperati...
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Media file 4: Phakic minus iris claw lens, 12 years postoperatively, in a 36-year-old patient shown in 3D. The lens is seen to sit on top of the iris cone. This picture helps to understand why the much larger angle-supported lenses have to be vaulted by 20° to keep clear of the iris.
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Phakic minus iris claw lens, 12 years postoperati...

Phakic minus iris claw lens, 12 years postoperatively, in a 36-year-old patient shown in 3D. The lens is seen to sit on top of the iris cone. This picture helps to understand why the much larger angle-supported lenses have to be vaulted by 20° to keep clear of the iris.

Phakic myopia iris claw lens, 11 years postoperat...
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Media file 5: Phakic myopia iris claw lens, 11 years postoperatively. The claws of the lens are shifted upwards. This configuration makes iris fixation in the claws easier at the time of surgery. It reduces the chances of pressure by the lens haptics and the optic on the natural lens and the iris, in case a bigger knuckle of iris is drawn inside the claw.
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Phakic myopia iris claw lens, 11 years postoperat...

Phakic myopia iris claw lens, 11 years postoperatively. The claws of the lens are shifted upwards. This configuration makes iris fixation in the claws easier at the time of surgery. It reduces the chances of pressure by the lens haptics and the optic on the natural lens and the iris, in case a bigger knuckle of iris is drawn inside the claw.

Anterior segment fluorescein angiography in a cas...
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Media file 6: Anterior segment fluorescein angiography in a case of iris claw lens (Artisan lens) in a phakic myope. There is no dye leakage. Courtesy of Professor Jan J. F. Worst, MD.
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Anterior segment fluorescein angiography in a cas...

Anterior segment fluorescein angiography in a case of iris claw lens (Artisan lens) in a phakic myope. There is no dye leakage. Courtesy of Professor Jan J. F. Worst, MD.

5-mm optic Artisan lens. Courtesy of Professor Ja...
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Media file 7: 5-mm optic Artisan lens. Courtesy of Professor Jan J. F. Worst, MD.
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5-mm optic Artisan lens. Courtesy of Professor Ja...

5-mm optic Artisan lens. Courtesy of Professor Jan J. F. Worst, MD.

6-mm diameter optic, Artisan lens. Courtesy of P...
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Media file 8: 6-mm diameter optic, Artisan lens. Courtesy of Professor Jan J. F. Worst, MD.
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6-mm diameter optic, Artisan lens. Courtesy of P...

6-mm diameter optic, Artisan lens. Courtesy of Professor Jan J. F. Worst, MD.

This 64-year-old patient had an iris claw lens im...
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Media file 9: This 64-year-old patient had an iris claw lens implanted in his aphakic eye on the posterior surface of the iris, 10 years ago. The white line represents the pupil in its normal state. Note fine pigment on the surface of the intraocular lens in this area. Bigger pigment granules are seen in the periphery. It seems that the pigment dispersed as a result of friction between the anterior surface of the intraocular lens and the posterior surface of the iris, over a very long time. This happened in spite of the fact that the posterior chamber was very roomy due to aphakia. Courtesy of Kiranjit Singh, MD.
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This 64-year-old patient had an iris claw lens im...

This 64-year-old patient had an iris claw lens implanted in his aphakic eye on the posterior surface of the iris, 10 years ago. The white line represents the pupil in its normal state. Note fine pigment on the surface of the intraocular lens in this area. Bigger pigment granules are seen in the periphery. It seems that the pigment dispersed as a result of friction between the anterior surface of the intraocular lens and the posterior surface of the iris, over a very long time. This happened in spite of the fact that the posterior chamber was very roomy due to aphakia. Courtesy of Kiranjit Singh, MD.

Gonioscopy in the same patient as in Image 9 with...
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Media file 10: Gonioscopy in the same patient as in Image 9 with iris claw lens fixed to the back of the iris. The angle shows severe pigmentation of the angle of the anterior chamber. Only the very finely pulverized pigment is deposited in the angle. Courtesy of Kiranjit Singh, MD.
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Gonioscopy in the same patient as in Image 9 with...

Gonioscopy in the same patient as in Image 9 with iris claw lens fixed to the back of the iris. The angle shows severe pigmentation of the angle of the anterior chamber. Only the very finely pulverized pigment is deposited in the angle. Courtesy of Kiranjit Singh, MD.

Gonioscopy in 3D of the other eye of the same pat...
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Media file 11: Gonioscopy in 3D of the other eye of the same patient as in Image 9 that received anteriorly fixed iris claw lens in the aphakic eye, 11 years ago. There is total absence of pigmentation in the angle of the anterior chamber. Courtesy of Kiranjit Singh, MD.
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Gonioscopy in 3D of the other eye of the same pat...

Gonioscopy in 3D of the other eye of the same patient as in Image 9 that received anteriorly fixed iris claw lens in the aphakic eye, 11 years ago. There is total absence of pigmentation in the angle of the anterior chamber. Courtesy of Kiranjit Singh, MD.

Postmortem appearances in an eye with an iris cla...
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Media file 12: Postmortem appearances in an eye with an iris claw lens showing the ciliary body and the posterior surface of the iris. There is a total lack of inflammatory or degenerative changes. Courtesy of Professor Jan J. F. Worst, MD.
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Postmortem appearances in an eye with an iris cla...

Postmortem appearances in an eye with an iris claw lens showing the ciliary body and the posterior surface of the iris. There is a total lack of inflammatory or degenerative changes. Courtesy of Professor Jan J. F. Worst, MD.

Besides producing optical problems, a decentered ...
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Media file 13: Besides producing optical problems, a decentered phakic intraocular lens, by taking the haptics closer to the limbus, makes the eye vulnerable to intermittent endothelial touch whenever the eye is forcibly rubbed. It can be prevented by a careful fixation during surgery. The decentered lens can be managed by opening the claws and refixation at the right place. Courtesy of Professor Jan J. F. Worst, MD.
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Besides producing optical problems, a decentered ...

Besides producing optical problems, a decentered phakic intraocular lens, by taking the haptics closer to the limbus, makes the eye vulnerable to intermittent endothelial touch whenever the eye is forcibly rubbed. It can be prevented by a careful fixation during surgery. The decentered lens can be managed by opening the claws and refixation at the right place. Courtesy of Professor Jan J. F. Worst, MD.

Eleven years after phakic minus iris claw lens im...
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Media file 14: Eleven years after phakic minus iris claw lens implantation in a 35-year-old patient, the pupil has been dilated for fundus examination. Iris claw lens does not affect the movements of the iris and the pupil, except at the point where the iris passes through the claw. The crystalline lens is not affected since the implanted lens remains far away from it.
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Eleven years after phakic minus iris claw lens im...

Eleven years after phakic minus iris claw lens implantation in a 35-year-old patient, the pupil has been dilated for fundus examination. Iris claw lens does not affect the movements of the iris and the pupil, except at the point where the iris passes through the claw. The crystalline lens is not affected since the implanted lens remains far away from it.

This phakic intraocular lens is fixated to the mi...
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Media file 15: This phakic intraocular lens is fixated to the midperiphery of the iris.
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This phakic intraocular lens is fixated to the mi...

This phakic intraocular lens is fixated to the midperiphery of the iris.

More on Myopia, Phakic IOL

Overview: Myopia, Phakic IOL
Workup: Myopia, Phakic IOL
Treatment: Myopia, Phakic IOL
Follow-up: Myopia, Phakic IOL
Multimedia: Myopia, Phakic IOL
References
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Further Reading

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Keywords

intraocular contact lens, internal contact lens, ICL, implantable contact lenses, angle supported phakic lens, iris fixated phakic lens, Artisan lens, iris claw lens

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Contributor Information and Disclosures

Author

Arun Verma, MD, Senior Consultant, Department of Ophthalmology, Dr Daljit Singh Eye Hospital, India
Disclosure: Nothing to disclose.

Coauthor(s)

Daljit Singh, MBBS, MS, DSc, Professor Emeritis, Department of Ophthalmology, Guru Nanak Dev University, Amritsar, India; Director, Daljit Singh Eye Hospital
Daljit Singh, MBBS, MS, DSc is a member of the following medical societies: All India Ophthalmological Society, American Society of Cataract and Refractive Surgery, Indian Medical Association, International Intraocular Implant Club, and Intraocular Implant and Refractive Society, India
Disclosure: Nothing to disclose.

Medical Editor

Daniel S Durrie, MD, Director, Department of Ophthalmology, Division of Refractive Surgery, University of Kansas Medical Center
Daniel S Durrie, MD is a member of the following medical societies: American Academy of Ophthalmology and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Louis E Probst, MD, Medical Director of Refractive Surgery, Chicago, Madison, Milwaukee, and Windsor Centers, TLC the Laser Eye Centers
Louis E Probst, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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