Name of the Procedure:

Phakic Intraocular Lens for Correction of Refractive Error (HCPCS Code S0596)

Common names: Implantable contact lens, Phakic IOL surgery

Summary

Phakic intraocular lens (IOL) implantation is a surgical procedure to correct refractive errors in the eye, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It involves placing a specially designed lens inside the eye while keeping the natural lens intact, providing a permanent alternative to glasses or contact lenses.

Purpose

The purpose of phakic IOL implantation is to improve vision by correcting refractive errors that cannot be adequately managed with glasses or contact lenses. The goal is to provide patients with good vision without the need for external eyewear.

Indications

• Moderate to severe myopia, hyperopia, or astigmatism not adequately corrected by glasses or contact lenses
• Patients with stable refractive errors for at least one year
• Clear and healthy lens and cornea
• Patients who are not good candidates for laser refractive surgery

Preparation

• Comprehensive eye examination to assess refractive error and eye health
• Discussion of medical history, medications, and allergies
• Fasting for several hours before the procedure may be required
• Stopping certain medications if advised by the doctor
• Preoperative diagnostic tests, including measurements of corneal thickness and eye length

Procedure Description

1. Anesthesia: The patient receives local anesthesia to numb the eye.
2. Incision: A small incision is made in the cornea.
3. Lens Insertion: The phakic IOL is folded and inserted through the incision, then unfolded and positioned in front of the natural lens.
4. Closing Incision: The incision may be closed with self-sealing techniques.

Tools and Equipment:

• Microsurgical instruments
• Phakic IOL
• Operating microscope

Duration

The procedure typically takes around 15 to 30 minutes per eye.

Setting

Phakic IOL implantation is usually performed in a hospital, outpatient surgical center, or specialized ophthalmology clinic.

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist (for local anesthesia)

Risks and Complications

• Infection
• Increased intraocular pressure
• Lens dislocation
• Cataract formation
• Glare or halos around lights
• Potential need for additional surgery

Benefits

• Improved vision quality
• Reduced dependence on glasses or contact lenses
• Stabilized refractive error correction
• Rapid vision improvement, often noticeable within a few days to weeks

Recovery

• Use of prescribed eye drops to prevent infection and reduce inflammation
• Avoid rubbing the eye
• Follow-up appointments to monitor healing and lens positioning
• Most patients can return to normal activities within a week

Alternatives

• Glasses or contact lenses
• LASIK or PRK laser eye surgery
• Refractive lens exchange

Pros and Cons of Alternatives:

• Glasses/contacts: Non-invasive but inconvenient for some activities
• LASIK/PRK: Permanent correction but alters corneal tissue and may not be suitable for high refractive errors
• Refractive lens exchange: Effective for high refractive errors but more invasive

Patient Experience

During the procedure, the patient will be awake but should feel only minimal discomfort due to the use of local anesthesia. Post-procedure, some mild discomfort, sensitivity to light, and blurry vision are expected for a few days. Pain management includes over-the-counter pain relief and prescribed eye drops.