Implantable Collamer Lenses (ICLs)
Implantable collamer lenses (ICLs) do what regular contact lenses do: Improve your vision. However, instead of being worn on the surface of your eye, they are implanted in the eye. If you are like many patients who are not good candidates for LASIK or PRK surgery, ICLs represent an opportunity to permanently improve your vision. In addition to being suitable for patients with thin corneas, ICLs are also able to correct a greater degree of myopia or nearsightedness than either LASIK or PRK.
ICLs are similar to the intraocular lenses (IOLs) used to replace a person’s cloudy lens in cataract surgery. However, unlike during cataract surgery in which your lens is removed, your natural lens will remain in place with ICLs. ICLs are also called phakic intraocular lenses. They work by changing the way that light enters your eye, focusing it properly on your retina. As a result, you are able to see distant objects more clearly.
The FDA has approved two types of ICLs for use in correcting moderate to severe nearsightedness: Verisyse® and STAAR® Visian® ICL. Both ICLs have been used for many years in other parts of the world, including Europe, before receiving FDA approval in the United States. Although both lenses are effective at correcting nearsightedness, the STAAR ICL has a slightly broader range, correcting from -3.0 to -20.0 diopters. In addition, the STAAR ICL is foldable and requires a smaller incision to implant. Since this incision also requires no stitches to hold the STAAR lens in place, your healing time may be shorter with this implant.
The STAAR implant is made of a collagen copolymer. Since collagen is a normal part of our bodies, it is not seen as a foreign substance by your eye. Once it is implanted, you will not feel it, and it will require no upkeep or care, such as that required by regular contact lenses. Studies indicate that 95 percent of patients are satisfied with their vision improvement from ICL implantation.
Prior to your implantable collamer lens surgery, you will require a comprehensive eye examination to determine if you are a good candidate for surgery and to determine the correct type of ICL. If you wear soft contact lenses, you will not be able to wear your lenses for three days before your exam and for three days before surgery. If you wear hard or RGP lenses, it will be necessary for you to stop wearing the lenses for several weeks before testing and surgery.
Two weeks prior to your ICL implantation, you will require a pre-operative procedure called a laser iridotomy. In this procedure, your highly skilled refractive surgeon will use a laser to create small openings in your iris to prevent post-operative glaucoma. This is also done as an outpatient procedure with minimal discomfort or inconvenience.
You should not eat or drink anything after midnight the night before your ICL surgery. On the day of surgery, you will be welcomed by a staff member. The staff will help you prepare for your surgery by putting eye drops in your eye. You will be given a gown to wear over your street clothes during your actual surgery.
The area around your eye will be thoroughly washed. Then your eye will be numbed, and you will be given a mild intravenous sedative to help you relax. Your surgeon will make a tiny incision in your eye. He will then insert the STAAR ICL behind your iris, the colored part of your eye, and in front of your natural lens. The lens implant surgery itself usually will take about 10 minutes.
After your surgery, you will rest in a comfortable reclining chair, and we will offer you some refreshments. Your family members may then join you in reviewing your follow-up care and schedule. You may be given medication or eyedrops to prevent infection.
Your entire outpatient surgical visit will take less than two hours. At that point, you will be able to go home. Since you will not be able to drive on the day of surgery, you should make arrangements for someone to drive you home. You will be called later in the day to check on your progress.
You will see your doctor the day after your surgery to monitor your healing. In addition, you will continue to be seen by the doctor for a series of scheduled follow-up visits to ensure that your vision is progressing normally.
Most patients who have implantable contact lens surgery are amazed at how well they see immediately after surgery. You can expect to continue all of your normal daily activities the next day. Your eye may be itchy, and there may be mild discomfort for a few days after the surgery, which is normal. You should avoid rubbing or pressing on the eye. If you notice crusty residue, you may use a clean, damp facecloth to gently remove it. In most cases, by the end of the first week after surgery, your vision should be stable, although it can take up to a month for your eye to fully heal.
With any surgical procedure there are risks. Some of these include infection, cataracts, glaucoma, detached retina, bleeding within the eye, and edema of the cornea or central retina. These conditions are usually successfully treated with medications or with additional surgery.
While some discomfort is normal, you should contact your doctor immediately if you have severe or increasing pain that does not respond to over the counter medication. If you should experience a sudden onset of floaters or flashes in your eye, this can be an indication of a detached retina. You should notify your doctor.
Although the FDA has only approved ICLs for the correction of nearsightedness, studies of their use to correct farsightedness are underway. In addition, the use of toric ICLs to correct astigmatism is also being studied. Therefore, the range and type of available ICLs should continue to grow.