Glare and halos after "phakic IOL" surgery for the correction of high myopia

Background. Phakic IOLs are currently under clinical investigation for the correction of high myopia with acceptable postoperative refractive results. Although daytime vision is usually very good some patients complain of vis ual disturbances, described as glare and halos, during the night time, lead ing to difficulties in driving vehicles. Patients and methods. The quality of vision after phakic IOL surgery was in vestigated pre- and postoperatively using various tests for objective measu rements of glare and halo in 40 myopic eyes (-9.0 to -20.0 D). Based on the implanted phakic IOL, eyes were divided into 4 groups of 10 eyes each wher e an Artisan 5.0 was implanted, an Artisan 6.0, a NuVita, and an ICL. Results. All patients were happy with the postoperative refractive outcome and during daytime no visual discomfort was reported. In contrast, most pat ients reported visual disturbances during dim light conditions and at night time, described as glare and halos. The objective measurements showed in m ost eyes increased glare and halos which was most prominent in eyes with an ICL, followed by the NuVita IOL. In contrast, patients with an Artisan 6.0 reported significantly less glare and halo problems. Conclusions. All currently available phakic IOLs, in particular the ICL and the NuVita lead to a decreased visual performance during night time. There fore, this phenomenon must be explained to the patient prior to surgery. An increase in the size of the optic should lead to an improvement with reduc tion of postoperative glare and halos.