Among the patients with refractive errors, almost 1/3 has high dioptry.
This ‘’unhappy’’ people hardly can help themselves with glasses. With high level of astigmatism, it is almost obvious that this conventional correction will not give good visual acuity and real picture. Unlimited visual field will be something that they will live with.
Without their glasses or contacts, these people can see only on few centimeters or half a meter, that means they are deeply dependent on glasses or contact lenses, with highly limited visual function, even with these aids.
Excimer laser in very high myopia, sometimes is not possible. It is limited by the height of dioptry and corneal thickness, therefore, lens surgery is the optimal solution.
In young patients, with accommodation present, the high refractive error will be corrected by phakic IOL implantation. That means the natural lens will not be changed, and therefore, will serve in action of accommodation. In older patients, with already lost accommodation, clear lens exchange (CLE) with artificial intraocular lens is the option.
Each of refractive procedures, laser or surgical, has its own specific requirements. To find the best and safest solution, for each patient, it is necessary to have extremely high experience and acknowledgement. Only with these principles, the outcomes of refractive procedures are outstanding. That is why thousands of people have changed their ‘’unhappiness’’ and started completely new lives. This is a surgical implantation of special intraocular lenses that can cover the high dioptric range.
The natural human lens, which lays behind the iris, stays untouched. That is why the accommodation (near vision) is preserved. The new-implanted lens will correct far vision. Refractive Phakic IOLs are used for high myopia, hyperopia and astigmatism (Phakic Toric) correction. Before decision about appropriate phakic IOL, it is necessary to do complete examination. The lens will be chosen for each patient individually. They are very well-tolerated, with quick adaptation and postoperative recovery.
There are two types of this implant:
STANDARD – lens is implanted in anterior chamber, fixed for iris, anteriorly (anteropupilar-in front of the pupil). Proper anterior chamber debth is needed as suggested depending on the power of the lens (not allowed for shallow anterior chamber).
It is not recommended to those who are at risk of injuries (e.g. sport players).
NEW, contemporary – lens is also fixed for iris, but on the back (retropupilar-behind the pupil), it gives better comfort to the patient, regarding reduced physical activities (ICL – implantable collamer lens).
It is popularly called ”implantable contact lens”.
Our results, after many years of doing these procedures, show better visual acuity, postoperatively, in comparison with best spectacle corrected before the surgery. The similar results are published from other world’s clinics, as well.
There is no sense speaking about high level of refractive surgery without great experience, long-lasting positive results, surgical skills and refined, precise and safe surgical techniques, and of course, the right choice for each patient’s eye. In the cases of high myopia, before any treatment, it is extremely important to completely check the fundus, complete periphery and macula, because in high myopia, there is a great possibility of changing in posterior pole, and risk of retinal detachment, for the whole life.
That is why it is important to prevent these situations, by early treatment, if discovered (laser photocoagulation of potential retinal ruptures, or early scleroplasty), before planning refractive surgery.
