Determining the Best Patient for the IPCL

Implantable phakic contact lenses (IPCL) provide effective long-term vision correction for both distance and near vision, with overall results that are stable, safe, and well-received by patients, according to Pavel Stodůlka MD, PhD.

In recent years, presbyopia-correcting phakic IOLs have been used in Europe, with consequent long-term clinical results reported, including those presented by Dr Stodůlka on the IPCL made by EyeOL UK. The lens is made in hydrophilic acrylic with a small incision size (1.8 to 2.2 mm) and features trifocal structures on the anterior surface of its optic provided in different additions, with a standard addition of +3 D for all patients. The new models include a central opening that is slightly different from other lenses in the market, and it is conical, which helps provide less light dispersion.

The very first lens was implanted by Dr Stodůlka in 2014. “At that time, we were seeking an appropriate group of patients for this implant, and I was also considering hyperopic patients, but now I use it primarily in myopes, including pre-presbyopes. It gives them the chance to stay spectacle free for longer,” he said.

The data presented included 26 eyes after seven years of follow-up. Patients enrolled were 48 years old on average, with an equal proportion of male and female patients. Distance refraction and uncorrected distance visual acuity (UDVA) remained stable over the seven years, with mean values of -0.3 and 1.0 logMAR, respectively. Cumulative UDVA data show 71% of eyes have at least 0.1 logMAR and 83% of eyes at least 0.2 logMAR, which indicates a particularly good distance visual acuity. The cumulative corrected distance visual acuity shows at least 0.0 logMAR in 96% of eyes at seven years, with a progression over time, he reported.

Regarding the cumulative uncorrected near visual acuity at seven years, 71% of eyes could read J2 or better, providing a high chance of long-term spectacle independence for near vision. Contrast sensitivity results in a small subgroup of 14 eyes showed normal photopic and mesopic values, with borderline mesopic values with glare. Despite the diffractive structure, contrast sensitivity is fine, with stable IOP and high subjective satisfaction. Overall, 90% of patients reported seeing halo and glare, but with minimal disturbance.

Complications in past models included some bleeding from iridectomy, which is no longer performed thanks to the centre opening. Pressure spikes were observed in 10% of cases using ophthalmic viscosurgical devices (OVDs), which Dr Stodůlka said he now avoids. No refractive surprise, proper sizing, or requiring lens exchange were observed.

Some useful tips to manage the implantation include folding the phakic IOL optic up, pushing the IPCL in the cartridge with the spatula before pushing it by the injector, and pharmacological miosis.

The lens provides fast distance visual rehabilitation, but it may take up to three months for near vision rehabilitation, he cautioned.

“It is an excellent indication for myopes more than 35 years old, which is a little bit earlier than most surgeons might consider,” he noted.

Dr Pavel Stodůlka spoke at the 2026 ESCRS Winter Meeting in Helsinki.

Pavel Stodůlka MD, PhD is founder, chief surgeon, and CEO of Gemini Eye Clinics in the Czech Republic and Vienna, Austria. stodůlka@lasik.cz