Continuity of Care and Long-Term Outcome Surveillance After Posterior Chamber Phakic IOL Implantation

Posterior chamber phakic intraocular lenses have a strong short-to-medium-term safety profile on the modern central-port platform, and a 2025 US Food and Drug Administration expansion of the indicated age range for a central-port phakic IOL to 21 to 60 years widens the eligible population. These lenses are to remain in the eye for decades, yet the field has defined what to monitor without building the infrastructure to deliver that monitoring reliably as patients age, change providers, and relocate. Existing guidance specifies endothelial and vault thresholds but does not address who monitors after the implanting surgeon, how baseline and longitudinal data transfer, or how late events are learned across practices. We propose three measures: upgrading the implant identification card into a longitudinal, portable surveillance record; a risk-stratified, age-informed surveillance framework developed through multisociety consensus; and a prospective implant registry with a defined minimum dataset. The device's clinical maturation now requires a parallel evolution in its care model.