SPECIAL COMMENTARIESPhakic intraocular lenses: an update and review for the treatment of myopia and myopic astigmatism in the United StatesMoshirfar, Majida,b,c; Webster, Court R.d; Ronquillo, Yasmyne C.a Author Information aHoopes Vision Research Center, Hoopes Vision, Draper bJohn A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City cUtah Lions Eye Bank, Murray, Utah dMichigan State University College of Osteopathic Medicine, East Lansing, Michigan, USA Correspondence to Majid Moshirfar, MD, Medical Director Hoopes Vision Research Center, Hoopes Vision Research Center, 11820 S. State Street Suite #200, Draper, UT 84020, USA. Tel: +801-568-0200; fax: 801-563-0200; e-mail: [email protected] Current Opinion in Ophthalmology 33(5):p 453-463, September 2022. | DOI: 10.1097/ICU.0000000000000870 Buy Metrics Abstract Purpose of review To review all phakic intraocular lenses (pIOLs) available in the United States for the correction of myopia or myopic astigmatism and offer a clinical approach to their proper use, postoperative follow-up, and analysis of visual and adverse outcomes. Recent findings In March 2022, the FDA approved the EVO/EVO+ Visian ICL for widespread use, adding this lens to the two others available (Verisyse, Visian ICL). Cataract formation, endothelial cell loss (ECL) and surgical reintervention remain the most common adverse events. There are discrepancies between studies on ECL following implantation with pIOLs, although trends can be deduced with meta-analysis. Posterior Chamber-pIOLs (PC-pIOLs), especially the EVO/EVO+, have an overall lower mean adverse effect and subjective patient symptom profile when compared to Iris Fixated-pIOLS (IF-pIOLs). Advancements in PC-pIOL sizing have provided a noticeable difference in visual and safety outcomes. Summary All pIOLs available in the United States provide high-quality visual correction of moderate to high myopia and/or myopia with astigmatism. Proper follow-up for ECL and cataract formation is warranted. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.