An implantable collamer lens (ICL) is an artificial lens which is permanently implanted in the eye. The lens is used to treat:

• myopia (nearsightedness)
• hyperopia (farsightedness)
• astigmatism

Implanting an ICL requires surgery. A surgeon places the lens between the eye’s natural lens and colored iris. The lens works the eye’s existing lens to bend (refract) light on the retina, which produces clearer vision.

The ICL is made of plastic and a collagen called collamer. It’s a type of phakic introcular lens. “Phakic” refers to how the lens is placed in the eye without taking out the natural lens.

Though ICL surgery isn’t necessary to correct vision problems, it can eliminate or reduce the need for glasses or contact lenses.

It’s also a possible alternative for people who can’t get laser eye surgery. But like most procedures, ICL surgery isn’t for everyone.

ICL surgery

You’ll visit your ophthalmologist one week before the surgery. He’ll use a laser to make tiny holes between the front of your eye (anterior chamber) and natural lens. This will prevent pressure and fluid buildup in the eye after the procedure.

You might also be given antibiotics or anti-inflammatory eye drops several days before surgery.

The procedure is done by an eye surgeon. Generally, here’s what happens:

1. You’ll lie down on your back. You’ll be given a mild topical or local anesthetic. This numbs your eye so you won’t feel anything.
2. You might be given a mild sedative to help you relax. You might also get an injection around the eye to temporarily stop you from moving it.
3. Surgeon will clean the eye and the area around it. Your eyelids will be held open with a tool called a lid speculum.
4. And surgeon will make a small incision in your eye. They’ll put a lubricant to protect your cornea.
5. They’ll insert the ICL through the incision. The lens is very thin, so it might be folded then unfolded in the eye.
6. Your surgeon will remove the lubricant. Depending on the incision, they might close the opening with small stitches.
7. They’ll put eye drops or ointment in the eye, then cover it with an eye patch.

The procedure takes 20 to 30 minutes. After, you’ll be taken to a recovery room where you’ll be closely monitored for a few hours.

Your doctor might prescribe eye drops or oral medication for the pain. You can go home the same day, but you’ll need to have a ride.

You’ll have a follow-up appointment the next day. Your surgeon will examine the eye and check on your progress.

Within the next year, you’ll have follow-up visits 1 month and 6 months after surgery. Your doctor will also have you return for regular checkups once a year.

Benefits of having an implantable collamer lens

In addition to improved vision, there are numerous benefits of an ICL:

• It can fix severe nearsightedness that can’t be corrected with other surgeries.
• The lens is less likely to cause dry eyes, which is ideal if your eyes are chronically dry.
• It’s meant to be permanent but can be removed.
• The lens provides great night vision.
• Recovery is usually quick because tissue isn’t removed.
• People who can’t get laser eye surgery might be good candidates for ICL.

ICL risks

Though ICL surgery has been shown to be safe, it may cause complications such as:

• Glaucoma. If the ICL is oversized or isn’t correctly positioned, it can increase pressure in your eye. This can lead to glaucoma.
• Vision loss. If you have high eye pressure for too long, you might experience vision loss.
• Early cataracts. An ICL can decrease the circulation of fluid in your eye, which increases your risk of cataracts. This might also happen if the ICL isn’t sized properly or causes chronic inflammation.
• Blurry vision. Blurry vision is a symptom of cataracts and glaucoma. You might also have other visual problems, like glare or double vision, if the lens isn’t the right size.
• Cloudy cornea. Eye surgery, along with age, reduces endothelial cells in your cornea. If the cells decrease too fast, you might develop a cloudy cornea and vision loss.
• Retinal detachment. Eye surgery also increases the risk of your retina detaching from its usual position. It’s a rare complication that requires emergency attention.
• Eye infection. This is also an uncommon side effect. It can result in permanent vision loss.
• Additional surgery. You may need another surgery to remove the lens and correct related issues.

Precautions

ICL surgery isn’t safe for everyone. When considering the procedure, talk to a doctor to determine if it’s right for you.

The surgery may not be a good choice if you:

• are pregnant or breastfeeding
• younger than 21 years old
• are 45 and older
• have a chronic disease that causes hormone fluctuations
• are taking medicine associated with vision changes
• have a condition that inhibits proper wound healing
• don’t meet the minimum requirements for endothelial cell count

Before the surgery, you’ll also need to take other precautions. For example, you’ll have to stop wearing contact lenses in the weeks leading up to the procedure.

Your doctor can explain the best safety measures for your situation.

ICL surgery vs. LASIK

LASIK is another type of eye surgery. Like ICL surgery, it’s also used to treat nearsightedness, farsightedness, and astigmatism. But instead of implantation of a permanent lens, it uses a laser to correct vision problems.

LASIK stands for laser-assisted in situ keratomileusis.

A surgeon uses a cutting laser to slice a flap in the front of the eye. Next, they use a programmed laser to remove a thin piece of tissue from the cornea. This allows light to refract on the retina, which improves vision.

When the surgery is done, the flap is returned to its normal position. It typically doesn’t need stitches to heal.

Since LASIK removes tissue from the cornea, you might not be a good candidate if you have a thin or irregular cornea. In this case, ICL surgery might be a better choice.

Takeaway

ICL surgery can permanently reduce your dependence on glasses or contact lenses.

Usually, the surgery takes about 30 minutes and recovery is quick. The procedure is also considered to be safe, but it may cause side effects like cataracts or vision loss.

Your doctor can help you decide if ICL surgery is safe for you. They’ll consider factors like your age, eye health, and medical history.

ICL Surgery Cost?

The ICL Surgery Cost in Pakistan varies from 250,000 to 350,000 PKR per eye.

Who is the best eye surgeon for ICL Surgery?

Brig(R). Dr. Muhammad Amer Yaqub is the best eye surgeon to perform ICL Surgery. He has more than 32 years of experience. He is also performing PRK, Femto Lasik, Cataract & Oculoplastic Surgeries. Currently he is practicing in The Eye Consultants eye hospital Rawalpindi.