ICL Implantable Collamer Lens
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WHAT IS ICL (IMPLANTABLE COLLAMER LENS)
ICL (Implantable collamer lens) is a type of Phakic IOL used for vision correction. In simpler words, it is a customised contact lens that is designed to be inserted into your eye and works with your natural eye to correct your vision. The STAAR Visian ICL is a boon for patients wanting to get rid of spectacles and contact lenses, especially those patients who are found to be unfit for Laser Vision Correction. While contact lenses are worn over the surface of the eye and provide temporary vision correction, the ICL is put inside the eye and the vision correction is permanent.
ICL is approved by the USFDA for vision correction and is being used world over since the last 16 years.
It provides high definition quality of vision, and a flapless procedure since there is no tampering of the cornea, so no problems of dry eye.
Who is a good candidate for Visian ICL?
A patient looking for refractive surgery to get rid of glasses must meet the following criteria to be fit for Visian ICL
Atleast 18 years old
Nearsighted with mild to severe myopia (-3D to -20D)
Stable spectacle prescription for atleast 1 year – minor changes of upto 0.5D do not disqualify a patient from undergoing ICL
Absolute indication of ICL –
Patient found unfit for LASIK
High refractive error of more than -9D upto -20D, cylindrical power upto -6D
Patient with thin corneas (Corneal thickness less than 470 microns)
Patients with preexisting Dry Eye
Patients of stable keratoconus, wanting permanent vision correction and unable to wear scleral lenses
What is the ICL made of?
The Visian ICL is made of a collagen polymer (Collamer). This collamer is a proprietary material used exclusively by STAAR Surgical in Visian ICL . This material contains collagen which naturally occurs in your body. The unique characteristics of this collamer that make it an ideal material for a vision correction lens are –
Biocompatibility – Collamer is a unique material that contains collagen which means the lens is made to naturally be in harmony with your eye.
Soft and Pliable – ICLs are easy to implant in the eye because of the soft and flexible structure. And they feel natural in the eye.
UV Protection – The unique Collamer material creates a barrier and provides UV protection.
What tests are performed before ICL surgery?
Before you are scheduled for your ICL procedure, the doctor performs a series of tests to measure the unique characteristics of your eyes. The size of the ICL ordered is customized based on the measurements taken on your eyes. These include
Dilated Refraction
Corneal Topography
Intraocular Pressure check up
Retina check up to ensure the patient has a healthy retina
Horizontal White to White (Limbus to limbus) measurement
Anterior Chamber Depth
Tear Film analysis
Specular Microscopy for endothelial cell density
What are the Benefits of ICL Surgery?
The ICL has been approved in the U.S. since 2005. The ICL has a patient satisfaction rate as high as 99.4% and over 10,00,000 procedues have been performed worldwide with an excellent track record.
The potential benefits for the patient are –
Flapless procedure, as the cornea remains untouched.
No risk of dry eye
High definition vision which is sharp and crisp
Excellent Night Vision
Preferred choice in thin corneas
UV protection is inbuilt in ICL
It is a reversible procedure – which means, that just like the ICL is inserted into the Eye through a small incision, it can be removed anytime if the need arises.
Can correct a wide range of power – The Visian ICL is approved for correction of upto -20D of myopia and upto 6D of astigmatism
Advanced Aquaport Technology – Unlike the older versions of the ICL, the newer version has a modified design with a central Aquaport, through which aqueous can pass, thereby eliminating the need for a preoperative peripheral iridotomy.
What are the possible risks of ICL Surgery?
The Visian ICL is USFDA approved, which means there has been a lot of research to ensure its safety and effectivity. However as with any procedure, there are few rare risks which need to be considered.
Risk of Infection – All surgical or refractive procedures involve some form of invasiveness which means there is a risk of infection. Although the risk of infection is uncommon, its important to realize that an eye infection can have a range of results, from delayed healing to serious eye damage.
Halos & Night Glare – Although very rare, even with Visian ICL there is a small possibility of residual halos and glare around lights at night.
Damage to Crystalline Lens(Cataract) – Since the Visian ICL is placed inside the eye and rests in front of the natural crystalline lens, there is a potential risk in touching the eye’s natural (crystalline) lens. Although the risk is less than 1.0%, damage to the natural (crystalline) lens may cause an opacity (cataract) of the lens and, may require removal of the cataractous natural lens and replacement of the natural (crystalline) lens with an intraocular implant (IOL).
Increase in Eye Pressure – In some cases, an increase in eye pressure can occur as a result of the procedure. In case it happens , your doctor would correct the problem with additional medication or surgical intervention.
Who should NOT have Visian ICL surgery ?
The following are contraindications to Visian ICL surgery –
If your doctor determines that the shape of your eye is not an appropriate fit for the Visian ICL
You are pregnant or nursing
You do not meet the minimum endothelial cell density for your age at the time of implantation as determined by your eye doctor
Your power is not stable as determined by your eye doctor
Before considering Visian ICL surgery you should have a complete eye examination and discuss with your eye doctor about the potential benefits, risks, and complications. You should discuss the time needed for healing after surgery.
What are the types of ICLs ?
The Visian ICL (Implantable Collamer Lens) is manufactured by STAAR Surgicals and is imported from Switzerland. This lens is made of collagen polymer, which is biocompatible with the human body. This material is the proprietory material of STAAR surgicals. The EVO visian ICL is the newer model of Visian ICL itself. EVO stands for evolution in vision correction
EVO + Visian ICL is also available which is customized to have a large optic size, used in patients with larger size pupil.
The EVO visian TICL is available where T stands for “Toric” ICL. The TICL is used for patients with Astigmatism.
What is the difference between Visian ICL and the EyePCL?
In last few years few Indian companies have started manufacturing phakic IOLs by the name of EyePCL or IPCL. However the material of these Phakic IOLs is hydrophilic Acrylic and not collagen. Although results of these Indian versions of ICL are promising, until now long term safety and efficacy studies have been done on Visian ICL and only the Visian ICL is USFDA approved.
