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What is Implantable Contact Lens (ICL) ?

Implantable contact lens (ICL) is a vision correction surgery. The implantable contact lens are foldable lens that are placed behind the iris (coloured part of the eye) to enhance the focusing abilities of the eye’s natural lens.

 

It is safe, effective and reversible, and its main advantage is that it does not change the shape or thickness of the cornea.

 

Lasik, on the other hand, alters the shape of the cornea. LASIK is a surgical procedure that uses a laser to correct near sightedness, farsightedness, and/or astigmatism.

 

In LASIK, a thin flap in the cornea is created using either a microkeratome blade or a femtosecond laser. The surgeon folds back the flap, then removes some corneal tissue underneath using an excimer laser. The flap is then laid back in place, covering the area where the corneal tissue was removed.

 

The Visian ICL is able to correct myopia of -3.0 D to -20.0 D (US FDA approved). Toric models can correct both myopia and astigmatism simultaneously.  This eliminates the need for subsequent procedures to correct astigmatism.

 

Can I remove the implanted lens if I change my mind in future?

The implanted lens can be removed in the same way it was implanted.  The process is reversible. However, this will mean another intraocular surgery and comes with its related risks.

 

What happens when I get lau hua ( Presbyopia) later on?

The ICLs do not prevent or delay the onset of presbyopia.  Reading glasses may still be required for those who develop presbyopia.

If you are already in your forties you may discuss with your doctor to opt for mono vision which gives you good far and good near vision.

What happens when I develop cataract later?

The ICL procedure does not prevent or slow down cataract formation.

If a cataract operation is required, the ICL is first removed safely. Then a normal cataract surgery can be performed. A new intraocular lens for cataract surgery can be inserted to correct the inherent refractive error but not presbyopia.

What are the possible complications and eye problems for ICLs?

The risks for ICL are generally low. However, since it is an intraocular procedure, the risk of serious sight threatening complications is slightly higher as compared to cornea surgeries such as LASIK.

The complications of the surgery and possible eye problems may include:

  • Infection of the intraocular tissues or endophthalmitis (1 in 1000 risk). Although rare, it is a potentially sight-threatening complication. If severe, vision could be permanently lost.
  • Rise in intra ocular pressure in the eye soon after surgery. However, the risk for this complication reduced by performing a procedure known as laser iridotomy before the ICL implantation as a routine.
  • Risk of cataract developing. If the occurrence significantly affects vision, then it is advisable that the ICL be removed followed by a cataract operation with a replacement Intra Ocular Lens (IOL) implantation be done.

 

The complications are similar to those in a cataract surgery.

 

Is ICL safe ?

Generally, the risk for ICL is low.

ICL has been in the market for more than 10 years.  There are many published clinical trials with long term results. These documented long term trials have shown ICL to be safe and effective. The US FDA approved its use in December 2005 for myopia.

ICL is an approved procedure in Singapore and has been used since 2005. It is approved for use in USA, Europe and in 45 countries.

Over 100,000 ICL procedures have been performed worldwide.

What happens during the ICL procedure (intraocular lens surgery)?

The implantation of an ICL is an intraocular lens surgery that can be performed as an outpatient procedure at a day surgery clinic.

Prior to the surgery – Laser Irridotomy

5 days prior to the surgery, a very focused beam of light is used to create small opening is created at the top of the iris (which is invisible to the naked eye) to allow better aqueous flow in the eye. This opening prevents sudden build-up of pressure within the eye.  This process is known as Laser iridotomy.

During the surgery

On the day of surgery, most patients will be operated under anaesthesic eye drops and mild sedation. Some patients may prefer general anaesthesia.  Anaesthesia is applied to numb the eye.

During the procedure, a micro opening is made in the cornea and the ICL is Inserted into your eye between the iris (the colored part of your eye) and the natural lens.  The micro opening is made without removing the eye’s natural lens. This lens works with the eye’s natural lens to improve vision.

The ICL does not alter the shape or thickness of the corneal tissue. The procedure is safe, effective and reversible. The small incision acts like a self sealing valve and usually stitches are not necessary.

The ICL is Inserted of your eye between the iris (the colored part of your eye) and the natural lens. The ICL is inserted into the eye with a special injector.

The lens is planted in position in front of the natural eye lens.  A gel substance is also injected into the eye with it to help settle the lens in the right place. After the surgery, the gel is removed.

The procedure takes around 10 to 15 minutes for each eye. Most patients find the procedure pain-free and easy to tolerate.

 

Is ICLs the correct eye treatment for me?

ICL is suitable for patients who are

  • at least 21 years of age, have myopia up to -20.00 diopters (2,000 degrees) with or without astigmatism.
  • have not had a change in their eyeglass prescription of more than 0.5D in a year.
  • are not pregnant
  • do not have significant active ophthalmic conditions like glaucoma, iritis or diabetic eye disease.
  • should preferably not have any previous surgery done or any systemic conditions such as diabetes and hypertension.
  • were non-LASIK candidates because of dry eyes, severe myopia, or have a thin cornea or have higher of near sightedness.

You will need to complete a thorough ophthalmic examination to ascertain if this is the correct eye treatment for you.

Is ICLs suitable for eye conditions such as high myopia, astigmatism, dry eyes?

The ICL procedure is a reversible procedure that is able to correct eye conditions such as high myopia as well as astigmatism.

ICL can correct up to

  • myopia up to 1900 degrees
  • long sightedness up to 1000 degrees
  • astigmatism up to 600 degrees

According to the Food and Drug Administration of the United States, research data from a 3 year study showed that ICL is safe and reliable for the treatment of myopia. 526 eyes and 294 patients were assessed in the study over a period of 3 years.

Summary of the study:

  • 99 % of patients were satisfied/very satisfied with their results.
  • 98.3 % of patients had uncorrected visual acuity of 20/40 or better.
  • Once vision was corrected, the correction was stable and did not change over the follow up period.
  • The incidence of glare, halos, double vision, night vision problems and night driving difficulties decreased or remained unchanged from before surgery.

You may refer to http://www.theeyeclinic.com.sg/vision_correction.php for more details of the clinical trials.

What are the advantages of implantable contact lens (ICL) ?

  • No cornea destruction
  • No side effects of dry eyes
  • No negative impact if cataract surgery is needed in old age
  • Suitable even for patients who cannot have lasik
  • Reversible procedure, if needed
  • Short recovery (1-2 days)
  • Lens are made of collagen (bio compatible)
  • It is clear and cannot be seen by the naked eye.

 

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