ICL surgery – Implantable lens for specs removal

If you have an eye-power and wear corrective eyewear like glasses or contact lenses then this procedure may interest you. Many with an eye-power consider getting their glasses removed. The most popular refractive surgery to get rid of glasses is Lasik or its various types. However, there are situations when a Lasik cannot be performed and ICL eye surgery is one of the surgical options. Thus, just like LASIK - Laser vision correction, ICL is performed in young adults.

What is ICL surgery?

ICL full form is Implantable Contact Lens, which is also commonly referred to as a Phakic Intraocular Lens (IOL). In this surgical procedure, a lens is placed in front of the natural lens of the eye. It's like placing a contact lens inside your eye so you do not have to wear it and take it out every day. ICL has been performed on over one million patients worldwide and is a highly effective procedure for achieving freedom from eyeglasses. 

When can Lasik not be performed? 

1. Thin corneas - pachymetry less than 470-480 microns
2. Keratoconus
3. Myopia more than -8 Diopters
4. Irregular Corneas
5. Other corneal diseases
6. Dry eye syndrome

Who is an ideal candidate for ICL Surgery?

1. Myopia or a refractive power greater than -8 diopters - ICL surgery can be considered as a treatment option for individuals with myopia or a refractive power greater than -8 diopters who want visual freedom from permanent contact lenses.
2. Thin Corneas - ICL surgery can be a suitable option for individuals with thin corneas who do not qualify for laser refractive surgery. Thin corneas may increase the risk of complications with traditional refractive surgery, but ICL surgery can provide a safe and effective alternative for vision correction.
3. Severe dry eyes - Traditionally Lasik eye surgery is known to cause dry eyes. If someone already has dry eyes then Lasik may not be a good option. In these situations it might be better to not perform Lasik and do an ICL surgery instead.
4. Keratoconus - the Visian ICL can be a good option for individuals with severe myopia caused by keratoconus.
5. Irregular Corneas - The irregular cornea may have cylindrical powers that might be difficult to get rid of in traditional Lasik Surgery. Irregular corneas may also be thin and thus Lasik may not be the best procedure. Here ICL surgery would be a much safer option.

Who is eligible for ICL Surgery?

Patients who are fit for LASIK/SMILE can also be eligible for ICL surgery. However, candidacy for each procedure depends on the individual's specific refractive error, corneal thickness, and other factors as mentioned above. A thorough eye examination and consultation with an eye surgeon can help determine the most appropriate treatment option for each patient.

Who should not undergo ICL surgery?

Some patients may want to get rid of their glasses but should not undergo ICL surgery, 

1. When the anterior chamber depth is shallow
2. When a patient is above 45 years of age - The reason for this is that after the age of 42 years, we all get reading glasses in some form or the other. If you were to undergo ICL surgery then while your distance power becomes zero your reading number remains and thus you still have to wear glasses.

The procedure to undergo above 45 years is called CLE (Clear Lens Extraction) or RLE (Refractive Lens Exchange). Here the natural crystalline lens of the eye is replaced with an artificial lens or IOL.

Types of ICL 

Two types of lenses are used in ICL eye surgery,

1. 1. Spherical ICL - These are used when patients only have spherical power and no cylindrical power.

   2. Toric ICL - A toric ICL is used when the person also has a cylindrical power or astigmatism. If we use a spherical ICL in this patient, there will be residual eye power left in the eyes. Since the whole idea of doing this ICL procedure is to get rid of glasses any patient who has astigmatism is implanted with a toric ICL.

Benefits of ICL Surgery

1. Quick and safe procedure - The procedure takes about 10 minutes per eye.
2. No procedure on the cornea, so no flap or lenticule was removed from the corneal tissue. (Smile procedures)
3. No complaints of dry eyes 
4. High quality of vision which glass free after surgery
5. Permanent Vision correction - When we say permanent we mean till you finally develop cataracts as an older individual, around 55 to 60 years of age.
6. When an individual gets rid of high eye power there is a significant improvement in the quality of life and now there is visual freedom. You are no longer dependent on eyeglasses to see clearly.

What is the process of ICL Eye Surgery?

You may be thinking of getting rid of glasses and you visit your eye doctor. Your eye doctor may mention ICL surgery as an option or may inform you that you are not a candidate for LASIK and thus ICL surgery is an option.

If you are keen to get this procedure for yourself the following is done.

Here’s is the step-by-step process of ICL Surgery

Complete eye examination

1. Vision check-up - Both distance vision and near vision.
2. Eye Power check-up
3. Intraocular pressure or eye pressure check-up
4. Retina and Optic nerve checkup

Investigations

1. A scan - Axial length measurement of the eye
2. Keratometry - Measuring the corneal curvature
3. Corneal Topography - Again measuring the corneal curvature
4. AC depth - Depth of the anterior chamber
5. Endothelial cell count in only some patients
6. Some other measurements

PRO TIP: If you are a contact lens wearer, please remove your contact lenses for a week before this examination.

Procedure performed before ICL surgery

Yag PI - This is a procedure done before the ICL surgery to create a small opening in the peripheral iris. It is done to reduce the chances of glaucoma after surgery.

Complications of ICL eye surgery

ICL surgery is a relatively safe procedure but, there are two most important complications of ICL surgery,

1. Cataract - A cataract is not a very common complication and we are not too worried about this because a cataract can be easily treated.
2. Glaucoma - The type of glaucoma is called pupil block glaucoma and the Yag PI is done to not let this happen.

Other complications that may happen after any eye surgery

1. Risk of infection

What happens after ICL surgery?

1. Right after surgery, the patient has blurry vision
2. May have light sensitivity for a few hours to a day
3. The patient will have to use eye drops for up to a month. These drops include antibiotic and anti-inflammatory drops
4. The same evening of surgery or the next day patient will have a clearer vision
5. The clarity of vision will improve as the days go by
6. You can resume your daily activities after a gap of a day
7. Your eye specialist will see you a few times in the following weeks to make sure everything is fine. He/she will also check your eye pressure to make sure you don't have glaucoma.
8. In a few days, you should have perfect vision without eyeglasses.

Companies that make ICL lenses

1. Staar Surgicals - EVO Visian 
2. Biotech - Eyecryl Phakic
3. IOCARE - IPCL V2.0

What is the cost of ICL eye surgery in Mumbai?

The implantable contact lenses don't have a fixed price. The prices range depending on the eye power but just to get an idea the cost would be around Rs 80000 - 100000.

ICL Surgery in Mumbai by Top Eye Surgeons at Eye Solutions

Eye Solutions has successfully performed innumerable ICL surgeries. Dr. Deepak Garg is the primary ICL surgeon at Eye Solutions. As mentioned earlier there is a detailed pre-surgery workup needed and only then would your surgery be planned.