Phakic IOLs (Intraocular Lenses) also known as Implantable Contact Lenses (ICLs) are an alternative to Laser Vision Correction (LASIK/ PRK/ SMILE) for correcting moderate to high myopia (nearsightedness) and hyperopia (farsightedness) with or without astigmatism, and in some cases produce better and more predictable vision outcomes than laser refractive surgery.
ICLs are surgically inserted into the eye and are placed in front of the natural lens inside the eye. It involves intraocular augmentation of the natural lens with additional lens without removal of natural lens and does not need to removal like a normal contact lens. ICLs are made of an advanced material that is extremely biocompatible and provides superior optical performance.
At MEC, we are proud to offer this state-of-the-art refractive error solution, especially useful for our patients who otherwise may not be fit for lasik surgery. This surgery corrects higher degree of refractive error. This procedure has many advantages including its correction of the widest range of refractive errors. At MEC, we prefer to chose or offer this procedure in case person is not fit for Laser Vision Correction Surgery or otherwise chooses ICL as his/ her procedure of choice after discussion with our doctors.
Types of Phakic IOLs
Many Phakic IOL types have been introduced in past with extremely good success rates. Nowadays, we commonly use one of two types of Phakic IOLs available.
The Staar Visian® ICL, also known as the Implantable Collamer® Lens, is premium offering from Staar Surgicals (Switzerland) made up of proprietary collamer material. Collamer, exclusive to STAAR Surgical and Visian ICL Products, is a biocompatible material used to create implantable lenses. ICLs are easy to implant in the eye because of the soft and flexible structure and they feel natural in the eye. The Collamer material that makes up lenses has unique properties that provide UV protection. It can be inserted through a 3.2mm sutureless incision and correct prescription upto -20D.
Indian versions are available made of hydrophilic acrylic material which has shown excellent biocompatibility as intraocular lenses (IOL) used during cataract surgery for years.The Implantable Phakic Contact Lens IPCL V2.0 (Care Group, India) is like a soft contact lens and can be inserted through 2.8mm sub-incision and can correct wide range of prescriptions from +15 to -30D with Cylinder up to 10D and also has “Add” options for presbyopia up to +4D.
Advantages of Phakic IOLs
- No Dry Eye Syndrome
- A Removable and Reversible Option
- Protection from UV Rays
- Able to correct a wide range of prescription (upto -30D)
- Great option for Thin corneas
What is involved in the ICL procedure?
Before you schedule your ICL procedure date, your doctor will perform a detailed preoperative examination and a series of standard tests to determine the suitability for procedure and to determine your eye’s unique characteristics for the procedure. This may also involve performing laser iridotomies (small holes in iris of eyes) sometime before procedure to ensure proper flow of fluid inside your eyes after the procedure.
The ICL surgery is performed on a day care basis which means that the patient has surgery and leaves the same day. The procedure itself usually takes 15-20 minutes or less. Your eyes are dilated before the procedure. A light topical (or local) anaesthetic (numbing drops) is administered just before the procedure. There is very little discomfort during or after surgery because of drops. A small incision is placed at base of cornea to insert the lens. The lens is folded and inserted inside the eye through it. Once inserted, surgeon makes the necessary adjustments to the lens to ensure proper position inside the eye. At this time the procedure is complete and some eye drops or medication will be prescribed to clean eyes and prevent infection. Although many have improved vision nearly immediately but you will need someone to drive you home on the day of surgery. A visit with your eye care professional is usually scheduled the day after surgery.
Frequently Asked Questions (FAQs)
Where is the IOL placed?
A trained ophthalmologist will place the IOL through a micro-incision, placing it inside the eye just behind the iris in front of the eye’s natural lens. The IOL is designed not to touch any internal eye structures and stay in place with no special care.
Does it hurt?
No, most patients state that they are very comfortable throughout the procedure. Your ophthalmologist will use a topical anesthetic drop prior to the procedure and may choose to administer a light sedative as well.
Can the IOL be removed from my eye?
Although the IOL is intended to remain in place permanently, an ophthalmologist can remove the implant in a very quick and short procedure.
Is the IOL visible to others?
No, the IOL is positioned behind the iris (the colored part of the eye), where it is invisible to both you and observers. Only your doctor will be able to tell that vision correction has taken place.
Will the patient be able to feel the IOL once it is in place?
The IOL is not like a contact lens over the eye. It is placed inside the eye and cannot be felt.
Will it interfere with cataract Surgery later on?
No, it does not interfere with cataract surgery measurements. It is easily removed during cataract surgery along with the cataract and an entirely new lens is put in place of the cataract.
What are potential risks of ICL Surgery?
Early complications (reported in the first week after ICL surgery) include: Shallowness of the front chamber of the eye that can create an increase of the pressure into your eye (may necessitate a peripheral iridectomy, read above), temporary corneal swelling (edema) and transient inflammation in the eye or iritis.
Complications after 1 week include: increase in astigmatism, loss of best corrected vision, clouding of the Crystalline lens (cataract), loss of cells from the back surface of the cornea responsible for the cornea remaining clear (endothelial cell loss), increase in eye pressure, iris prolapse, subretinal hemorrhage, retinal detachment, secondary ICL related surgeries (replacements, repositionings, removals, removals with cataract extraction), too much or too little correction, and additional YAG iridotomy necessary.