ICL Lenses for Myopia
ICL (Implantable Collamer Lens)
There are many people who are not able to benefit from Laser Vision Correction. The most common reasons for this are higher amounts of refractive error and abnormal corneas. Fortunately, we have a good solution for people in this category who want clear vision without glasses. By implanting a lens inside the eye, we can actually correct a higher degree of refractive error than is possible with the laser. For this, we use the STAAR VISIAN ICL, or Implantable Collamer Lens. This technique can also be used on eyes with stable mild to moderate keratoconus in many cases. Keratoconus eyes should not have Laser Vision Correction due to the danger of corneal ectasia (thinning.)
The ICL acts somewhat like a soft, clear contact lens which never has to be removed or cleaned. Since it is placed behind the iris, it is not visible to anyone else and is extremely well tolerated by the living tissues inside the eye. The difference between the STAAR VISIAN ICL and refractive lens exchange (RELEX) is that with the ICL the natural lens is left in place; with refractive lens exchange, the natural lens is removed and replaced with an artificial lens.
In general, people 45 or younger do better with ICL implantation since their natural lens is able to focus at near for reading, sewing, etc. People older than 45 usually do better with RELEX since their natural lens is no longer able to focus for near tasks, but the new artificial lens can focus at near quite well.
Both RELEX and ICL implantation require a trip to the operating room since sterile technique is needed to prevent potential infection. We must also perform a laser iridotomy two weeks prior to surgery when using an ICL. This is an important step needed to prevent glaucoma. Many find this step uncomfortable, but the discomfort is usually very brief, lasting only a few seconds. Visual recovery is very rapid following ICL with excellent vision present within hours for most. In some cases, especially when significant astigmatism is present, additional laser vision correction may be needed for best uncorrected vision. The amount of correction needed to be done with laser is usually fairly small which makes it easier, more predictable and safer.
What happens when an eye with an ICL inside it develops a cataract? The solution is very simple: the ICL is very easy to remove from the eye even if it has been in place for years. In fact, the ICL implantation is fully reversible at any time unlike most other refractive procedures. The ICL can simply be pulled from the eye (since it is very soft and foldable) and then cataract surgery can be performed in the usual manner.
The fact that the ICL is so easy to remove is a benefit in one other situation. Let’s say that a person had refractive surgery using an ICL in her early twenties and by age 30, her refraction had changed, becoming more nearsighted or more farsighted and once again requiring glasses or contact lenses for clear vision. What to do? We can easily remove the ICL and replace it with another ICL of a different power bringing the eye back into focus.
We are happy to offer this as another refractive option for our patients. Contact us to learn more about the ICL and whether it is the best solution for you.
