In a conversation with Dr. David Goldman, refractive editor of OphthalmologyWeb, Dr. John Vukich reviews the latest thinking in phakic IOL implantation. He also discusses some of the issues reviewed at ASCRS cornea day sessions: Endothelial cell density review in angle supported lenses. Safety of the various lenses. Design - distance from cornea. Dr. Vukich then describes patient selection criteria for phakic IOLs vs. LASIK: topography, corneal thickness. 4-6 D range done, but typically over 8D. Lowest power available is -3D. As opposed to LASIK, phakic IOL risk is independant of "dose". At all levels of surgery, the procedure is the same, and so is the risk, regardless of corrective power. Astigmatic patients can still benefit from phakic IOLs when coupled with LRIs, or perhaps a surface ablation. Phakic IOLs have enjoyed double digit growth year/year for 7 consecutive years.