December 28, 2022

What is ICL Surgery?

If you have struggled with myopia (short-sight) and other vision problems all your life, you’ve likely looked into what you can do to fix them. 

Most people use prescription glasses or contact lenses, but other refractive surgery options, like LASIK, offer a more permanent solution.

However, only some people are suitable for laser eye surgery.

In those instances, ICL surgery might be offered as an alternative. But what is ICL?

What Is Implantable Contact Lens Surgery?

ICL, also known as Implantable Contact Lenses or Implantable Collamer Lenses, are a special kind of intraocular lens developed to correct myopia (short-sightedness, near-sightedness) and astigmatism. They act as internal contact lenses that never needs cleaning or replacing.

The lenses are designed to be permanently implanted into the chamber in front of the eye’s natural lens, not to replace it (as with cataract surgery lenses), and work in the same way as a conventional contact lens. They sit behind the iris and are not visible to the naked eye.

The lenses are made from a unique blend of collagen and polymer and are designed to be hypoallergenic and biocompatible, causing no reaction within the eye.

Once the implantable contact lenses are inserted, they remain in place and do not need to be removed, except in certain rare situations. However, they are reversible and can be removed if ever required.

Like LASIK surgery, implantable contact lens surgery is used to correct short-sightedness and astigmatism, but because the process is a little more complex, and the cost of the lenses must be considered, it is a more expensive surgery.

Who Can Get Implantable Contact Lenses?

Usually, ICL is offered as an alternative refractive surgery because the patient isn’t a suitable candidate for LASIK. There are several reasons why someone would be recommended an ICL procedure over LASIK:

  • They are susceptible to dry eyes—the ICL doesn’t irritate or dry out the tear layer
  • They have extreme myopia that cannot be corrected with LASIK
  • Their cornea is too thin to allow laser surgery

ICLs are not recommended for people under 21 as the eyeball is still growing and changing shape into your twenties, and your prescription may alter.

Since the surgery is more expensive, and the lenses are manufactured to your exact specification, your prescription must have been stable for at least a year without any deterioration before you can be considered for ICL treatment. 

After 45, many people’s near vision slowly worsens as the natural ageing process makes the natural lens less flexible. This age-related vision impairment means that most eye clinics have a cut-off age of 45-50 for ICL surgery, though they are approved for use up to age 60.

Your ophthalmologist will check that you have no contraindications to getting ICL, test your eyesight for the correct prescription, and make sure the chamber behind your cornea is of sufficient depth for the lenses to be inserted. 

It’s also possible to treat patients with astigmatism thanks to so-called toric lenses. These ICLs can be inserted and rotated to the correct angle to correct short-sightedness and astigmatism simultaneously.

People with cataracts are not typically suitable for implantable contact lens surgery, though other surgery options are available.

Implantable Contact Lens Risks

ICL is considered safe, and the treatment effectively corrects poor vision. 

However, as with all surgery, there are always chances of complications. 

However, with over 2 million lenses prescribed worldwide, and a 99.4% positivity rate, the ICL surgery has a very high success rate.

Possible issues that may arise:

  • Incorrect placement of the lens, where it’s not centred correctly. Your ophthalmologist will need to correct this with a second surgery.
  • Loss of vision or changes in vision. The surgery may not always be successful and may cause further damage.
  • The lens may induce additional pressure inside your eyes. The feeling may pass as you adjust and eye pressure will need to be monitored.

While the surgery is quick and relatively painless, you’ll need to administer medicated eyedrops as prescribed after the treatment and undergo follow-up checks to ensure the lenses settle in properly. Failure to use the eyedrops correctly could result in a severe eye infection.

While most people experience itching or slight pain after the surgery, this usually goes away as the eye heals. Regular checkups with our clinical team will ensure your recovery is going as expected and allow us to address any issues quickly.

An implantable contact lens can also reduce fluid circulation within your eye, which may increase the risk of developing cataracts. Cataract formation was a risk with older ICL models and rare with today’s version.

Is ICL Surgery Painful?

Your eye surgeon will numb your eyes with anaesthetic drops before the treatment begins, and you shouldn’t feel a thing during the surgery.

However, you’re likely to feel a burning or itching sensation after the surgery as the anaesthetic begins to wear off, which may continue for a few days. However, we will give you medicated eye drops to help with the discomfort, and your surgeon will advise you on which over-the-counter medications you can use if necessary.

One of the most important things to remember in the weeks after the surgery is not to rub your eyes, as this could lead to an infection or severe discomfort.

What to Expect with ICL Surgery?

In the appointments before your surgery, your doctor will let you know how to prepare for the day. Preparation for ICL surgery may include avoiding certain medications, such as aspirin, for a week or more before the surgery date.

After you arrive at the clinic, we’ll perform a final set of checks and prepare you for the procedure.

During surgery, the ophthalmologist will make a painless small incision in the edge of your cornea and inject the rolled-up polymer lens into place. It will unfold on its own, and your doctor will gently manoeuvre it into position. There is no need for stitches, as the cornea will heal naturally.

This process takes about 20-30 minutes.

After surgery, you will wait in the recovery room for a few hours before we make sure you’re ready to go home. 

You’ll be given medicated eyedrops which you must use to avoid infection, and an eyeshield to protect your eyes for the first few days.

You’ll need to arrange to have someone collect you from ICL surgery, as you must not remove your eyeshields— the surgeon will do this at your next appointment.

Your vision will likely be misted until the corneas heal. It may take a while for your brain to adjust to your new sight. However, some of our patients can notice an immediate difference in their vision.

It’s best to take a few days off work to rest and avoid strenuous activity.

You’ll then have several follow-up appointments to ensure your eyes heal correctly before you’re finally discharged.

The Bottom Line

ICL surgery is an excellent choice for patients unsuitable for LASIK, such as people with thin corneas or high refractive errors. For very high prescriptions, ICL is the preferred choice of procedure.

It involves minor eye surgery to allow your doctor to implant a thin, flexible Collamer lens behind your natural eye lens, but it’s not suitable for everyone.

If you’re considering ICL surgery, or you’d like to find out which eye surgery is the right option for your prescription, you can schedule a free telephone consultation with a member of our team here.

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