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PCRIs and toric IOLs are currently the two main options for astigmatism management during cataract surgery. Refractive outcomes are improved by new techniques, which refine the effectiveness and accuracy of these two options.

Patient interest in refractive eye surgery is increasing, especially for correction of high levels of myopia and hyperopia. Outcomes of techniques that work well for correcting lower levels of error, such as excimer laser correction, fall short of patient expectations. These expectations have driven the development of new technology for correcting high refractive errors. A new technique, phakic intraocular lens (pIOL) insertion has proven to be safe and effective for treating high myopia and high hyperopia. In this article, the different types of pIOLs are discussed along with recently published results and complications of each design. Larger studies with long term follow up are needed.

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