Implantable Contact Lens (ICL / ICL Toric)

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Last updated 3/5/2020
Implantable Contact Lenses

What's an implantable contact lens?

An Implantable contact lens (ICL for short) is placed inside your eye in order to permanently correct your vision. An ICL can be placed either in front of, or behind, your iris (the colored part of your eye).

 

Other names for ICLs include implantable collamer lens and phakic intraocular lens.

 

ICLs provide an alternative to reading glasses or contact lenses for those patients who are not good candidates for LASIK due to severe myopia or astigmatism.

How are implantable contact lenses inserted?

 

 

After administering numbing eye drops, your surgeon prepares your eye to receive the new lens by making a tiny opening in your iris using a laser. This allows eye fluid to flow from the back of your eye (the posterior chamber) to the front of your eye (the anterior chamber) to regulate your eye pressure after surgery.

 

The following steps then vary based on which lens type is being inserted:

 

The Visian lens is rolled up like a very compact cigar within a pen-like device that inserts the lens in your eye through your cornea (the clear part of your eye surface). The lens is then positioned behind your iris (the colored part of the eye) and in front of your eye's natural lens.

The Visian lens is gently unfolded within your eye where it stays in place without stitches. The incision in your cornea is so tiny that stitches are not needed because it can heal on its own.

The Verisyse lens is introduced through a 6mm incision, made at the outer edge of your iris so that the lens can fit through it. The lens is then secured using very fine dissolvable stitches. Your corneal incision is also stitched closed.

Once your lens is in place, your doctor checks your intraocular pressure and then surgery is done. You are ready to be driven home by whoever is accompanying you. You will be sent home with detailed written instructions for your post-op care.

 

What can I expect after ICL surgery? 

Most patients experience mild discomfort after surgery and, you might feel irritation like there's something in your eye, but that will quickly disappear. Then you will not be able to feel your lens. Nor will the lens be visible to an outside observer looking at you

 

You will be prescribed medications for pain, as well as eye drops to prevent inflammation and infection. You will also be given eye shields to wear at night for the first week after surgery to keep you from inadvertently scratching your eyes.

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Implantable contact lens surgery recovery

Amazingly, most patients report clear vision the next day. And, in most of our patients, vision is quite stabilized within one week of surgery.

 

On the day after surgery, patients return to our clinic for a postop eye exam and then will return for check-ups at one month, two months and six months post-op. Most patients can resume normal activities within a few days after surgery and will be completely healed within one month.

 

Are there Implantable contact lens options?

Yes! At AEI, we offer two brands of FDA approved implantable contact lenses: VisianTM and VerisyseTM. Each one has unique characteristics that can make it the best option for certain circumstances. Both offer built-in ultraviolet filters that protect your eyes from UV rays.

 

Both brands also offer special ICLs designed for people with astigmatism, which are called Toric ICLs. You'll get this type of lens if you have a cornea that's more football-shaped than round. A toric ICL lessens the blurry vision caused by astigmatism so you won't need glasses to correct it after your ICL is inserted.

  

Visian brand implantable collamer lenses

Visian lens have been placed in over a million eyes worldwide since their FDA approval in 2005. These lenses are made of a thin pliable material called collamer that's a combination of collagen and polymer. Because collagen is made by the human body, our body doesn't recognize collamer as foreign. This lowers the Visian lens' rejection risk to nearly zero.

 

The Visian lens is inserted behind your iris (the colored part of your eye) and in front of the natural lens.

 

Visian provides excellent quality of vision. In fact, over 94 percent of patients in clinical trials reported excellent or good vision quality after receiving their ICL. What's more, over 98 percent said that they'd undergo Visian ICL implantation again if given the choice.

 

Verisyse ICLs

Verisyse are different from Visian in two important ways:

  • Verisyse are made of a rigid plastic material called polymethylmethacrylate (PMMA).
  • The Verisyse lens is placed in front of your iris (the colored part of your eye). This allows them to be easily swapped out if your vision changes over time.

 

Which ICL lens is best for me?

The appropriate lens choice will be determined by you and your eye doctor following a detailed eye exam using specialized equipment to measure your vision deficits, the shape of your eye and also identify any irregularities on the surface of your eye.

 

This is done to ensure the most precise vision correction and lens fit possible.

 

Am I a good candidate for implantable contact lens?

You are a good candidate for an implantable lens if:

  • You are between 21 and 45 years old
  • You don't qualify for LASIK or PRK due to a high degree of nearsightedness (myopia) or having thin corneas or dry eye syndrome
  • Your refractive error measures between -3.0 to -20.0 diopters
  • You have not had any prior eye surgery
  • You do not have certain eye conditions such as iritis, uveitis, glaucoma or diseases associated with poor tissue healing such as diabetic retinopathy, connective tissue disease or autoimmune diseases
  • You are not nursing or pregnant
  • Your vision prescription has remained stable for at least one year
  • Your eye exam confirms that you meet certain physical requirements needed for ICL implantation

 

Implantable contact lens surgery risks

Although no surgery is without risk, ICLs have been available for two decades in Europe and placed in nearly one million eyes, so they've been widely studied. However small the likelihood of a complication may be, you should be aware of it when considering ICL surgery.

 

Complications from ICL surgery can include:

  • Eye infection (known as endophthalmitis)
  • Cataracts can occur in one to two percent of patients up to seven years after surgery (the risk is higher in older patients with high degrees of nearsightedness)1
  • Glaucoma: Lens insertion can cause release of pigment from the iris that clogs the eye's drainage system, increases eye pressure, and leads to glaucoma
  • Retinal detachment (the risk of the retina detaching from the back of your eye is increased with any intraocular surgery)
  • Acceleration of normal corneal aging that can cause it to become cloudy2

 

ICL surgery follow-up

ICL patients should have their vision checked annually or sooner if they notice a change in their sight. Sometimes, such as with aging, patients' vision can change and they may benefit from exchanging their ICL for a different prescription lens. This procedure is done easily and with no more risk or recovery time than the original surgery.

 

Because highly nearsighted patients are the typical candidate for an ICL lens implant, their elongated eyeball shape puts them at higher risk of developing spontaneous retinal tears and also of getting cataracts.

 

As such, it is important for high myopes, including patients who have had ICL lens inserted, to have annual eye exams to monitor for the development of cataracts or retinal tears. Annual exams are important for anyone's eye health, but especially for highly nearsighted patients.

 

Why choose Assil Eye Institute for ICL surgery

When you select Assil Eye Institute for implantable contact lens surgery, you will benefit not only from our state-of-the-art technology and our physicians’ extensive experience, but also from our commitment to:

  • Perform comprehensive pre-operative testing using a number of tools to measure the health, dimensions and power of your eye, so that we can determine the most appropriate replacement lens power and design.
  • Utilize microsurgery technology when appropriate to facilitate faster healing without sutures. This technology also minimizes astigmatism and yields better visual outcomes.
  • Offer a comprehensive selection of Intraocular Lenses, to ensure the best product type and shape match for your eye.
  • Perform surgery utilizing anesthetic eye drops coupled with gentle IV sedation to provide for greater comfort and safety.
  • Dedicate ourselves to your post-operative care throughout your healing.

 

References

1. Anterior Subcapsular Opacities and Cataracts 5 Years After Surgery in the Visian Implantable Collamer Lens FDA Trial

Donald R. Sanders, MD, PhD 

Journal of Refractive Surgery. 2008;24(6):566-570

 

2. Implantable Collamer Posterior Chamber Intraocular Lenses: A Review of Potential Complications 

Paulo Fernandes, PhD; José M. González-Méijome, PhD; David Madrid-Costa, PhD; Teresa Ferrer-Blasco, PhD; Jorge Jorge, PhD; Robert Montés-Micó, PhD

Journal of Refractive Surgery. 2011;27(10):765-776

  • Dr. Kerry Assil, Beverly Hills LASIK and Cataract Surgeon

    Kerry K. Assil, MD, is regarded as one of the world’s foremost experts in refractive surgery, having made significant advances in the field with his numerous inventions. Additionally he has the unique distinction of having trained thousands of eye surgeons in the latest refractive surgical techniques.

     

    Dr. Assil has authored more than one hundred textbooks, textbook chapters and articles on refractive surgery and has appeared regularly on major television network news programs as a pioneer in refractive surgery. He also leads educational forums for other eye care professionals, which have included featured lectureships at Harvard University, Johns Hopkins University and Tokyo University.

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