The surface of the eye is made insensitive with anesthetic eye drops. An anesthetist can administer pain and sedatives through a vein on the arm as needed. The PIOL (3) is rolled up when inserted and slides through a small tube into the eye, where it slowly unfolds. With specially designed instruments, the soft lens is carefully guided at its corners into the space (sulcus ciliaris) between iris (arched skin) and natural lens (1). PIOL corrects the focal point in such a way that a sharp image of the environment on the retina is created (4).
In contrast to refractive laser eye surgery, PIOL implantation takes place inside the eye. This results in a low risk of intraocular infections and therefore requires a sterile operating room.
For corrections of minor to moderate vision defects, the laser eye procedure is preferred over a PIOL for normal corneas. The reason for this is primarily that laser eye surgery “only” treats the cornea while the PIOL is implanted inside the eye. Even though the risk of a serious complication is very low when implanting a PIOL, this is still lower with laser eye treatment.
PIOL is therefore primarily recommended for patients who have severe vision defects:
PIOL is also being considered for patients who are not suitable for laser eye surgery due to thin or irregular corneas.
In the case of keratoconus, PIOLs should only be implanted when keratoconus progression has stopped and the cornea is stable. Otherwise, a Crosslinking treatment be considered.
In patients with high farsightedness, the eyeball is smaller than in people with normal vision. Accordingly, the anterior chamber is usually too flat to safely implant a PIOL and no standard refractive operation can help the affected patient to achieve freedom from glasses or contact lenses.
These requirements comply with Recommendations from the Refractive Surgery Commission — KRC as of June 2022
Since the procedure is performed on an outpatient basis, you should be picked up by an accompanying adult, as visual acuity is reduced after the operation. Your ability to react can also be reduced by narcotics, painkillers and sedatives.
Use prescribed medications regularly.
5 days before surgery
1st day of surgery until the first check
1st week
2nd week
3rd week
4th week
1 day after surgery: control of eye pressure, vision, inflammation in the eye and location of the PIOL
1 week after surgery: check whether vision has been achieved
1 month after surgery: check the position of the PIOL in the eye and retina
After that, we recommend annual checks
As soon as one of the above requirements cannot be met.
No, the PIOL is positioned in front of the natural lens.
In the first few hours after surgery, vision is usually not yet completely clear and there may be glare. Even on the first day after surgery, vision is usually clear and sharp.
There are several PIOLs from different manufacturers, the most common being the ICL® from STAAR Surgical® and the IPCL® from CareGroup®. Both are made from biocompatible, i.e. materials that are easily compatible with humans. However, the exact components are still an industry secret.
No, the implant is neither visible to the operated patient nor to others. With the microscope, the position and position of the implant can be assessed.
No, the implant is not noticeable. Since the PIOL is inserted in the back chamber of the eye, it cannot move.
The PIOL cannot be worn out, nor is the material attacked by the body's cells. Since the lens is implanted inside the eye, neither dirt nor bacteria can collect on it.
The main risks include increased intraocular pressure, which is manifested by severe pain, nausea, and blurred vision. Eye pressure can be reduced quickly and specifically with medication.
Inflammation in the eye can be treated with anti-inflammatory drugs or cortisone. In the case of a very rare infection inside the eye, another operation is necessary to preserve vision.
The implanted lens can lead to premature opacity of the natural lens come. Today's IPCLs are mostly equipped with so-called aquaports, which improve the circulation of chamber water, which prevents premature cataract formation. Almost all people experience clouding of the natural lens over the course of their lives, which is associated with a cataract surgery can be fixed.
PIOLs can lead to clouding of the front natural lens, which can first cause glare and later also a decrease in vision. The newer generation of PIOLs therefore has small pores (aquaports) through which the anterior chamber water flows and thus a nutrient exchange can take place.
The risk of clouding the natural lens is lowest when the distance from the implant to the natural lens is large enough.
The inserted implant can rarely reduce the outflow of anterior chamber water and may result in an increase in eye pressure and thus damage the optic nerve.
Very rarely, implanted PIOL has a negative effect on the endothelial cells at the back of the cornea.
Basic insurance is generally not allowed to cover the costs of laser eye surgery or the implantation of PIOLs.
If the patient cannot tolerate contact lenses and the difference in defective vision between one eye and the other eye is more than three diopters (anisometropia), health insurance must cover the cost of one eye.
Supplementary insurance often covers part of the costs of refractive procedures. In case of doubt, we recommend that you check this with your health insurance company in advance.
