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22 Phakic IOL implantation
22.3 Patient selection criteria
by Prof. Burkhard Dick, Sabine Buchner, Optometrist
Careful pre-op evaluation and patient selection are essential prerequisites for a successful
implantation. There are several criteria that have to be considered. In our clinic, we look at the
following:
The minimum clearance between pIOL and endothelium should be greater than 1 mm;
Endothelial cell density should be at least 2000 per mm²;
Dislocation of the pupil should be no greater than 1 mm. The Scheimpflug image in Figure 183
shows a dislocation by approx. 1070 μm;
The cornea and crystalline lens should be clear;
Iris convexity: If the iris is very irregular, it is better to refrain from pIOL surgery. The Pentacam®
pIOL simulation in Figure 184 shows an iris convexity of more than 15 degrees.
Figure 183: Scheimpflug image showing a both visible and measurable pupil dislocation
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