[Phakic intraocular lenses. Current status and limitations].

Phakic intraocular lenses (PIOLs), which are located closer to the eye's nodal points than the anterior corneal surface, can provide superior optical quality for higher corrections because of retention of normal prolate corneal asphericity and larger effective optical zones. Improvements in the material and design of phakic intraocular lenses and their insertion devices combined with advances in the understanding of the anatomical and physiological interactions of the PIOLs with intraocular structures, have increased safety and efficacy. Safety of these implants over the long term remains a concern, but in several situations PIOLs are the refractive correction of choice. The purpose of this review is to compare the different types of PIOLs regarding outcome and complications. Improvements in imaging technologies should improve the accuracy of ICL sizing and allow more precise prediction of effective lens position with more accurate power calculation. It is important to inform patients that phakic lens surgery only corrects the refractive aspect, and that the refractive error itself as well as the changes by surgery still has the potential for serious complications.