Implantation of an opaque intraocular lens (IOL) for intractable double vision is technically similar to standard cataract surgery. It is indicated only in highly selected patients. In this context the evidence on safety and efficacy, which is limited to a small number of patients, appears adequate for the procedure to be used provided that normal arrangements are in place for clinical governance and audit.
During the consent process clinicians wishing to undertake implantation of an opaque IOL for intractable double vision should take the following actions:
Ensure that patients and their carers understand that the removal of the natural lens required for this procedure is irreversible. If removal of the implanted opaque IOL were ever required, then damage to ocular structures would be a risk. They should provide them with clear information. In addition, the use of NICE's information for the public is recommended.
Patients should only be offered implantation of an opaque IOL when all alternative treatment options for their double vision have proved inadequate.