There are several surgical options available to improve vision and eliminate dependence on eye glasses. The available choices of permanent vision correction procedures include LASIK, PRK, and an Implantable Collamer Lens, ICL.
The ICL is an artificial lens, similar in function to a contact lens, and in structure to an intraocular lens. The ICL is implanted in front of the eye’s natural lens, in the space behind the iris, so that it is invisible to outside observers and the patient. Unlike LASIK, which is a surface procedure, and requires removal of a part of the cornea, ICL is an intraocular surgery. The ICL procedure has been approved by regulatory authorities for the correction of moderate to severe myopia.
Even though LASIK, laser for removal of spectacles, remains the most popular refractive surgery, ICL is fast gaining popularity with both eye surgeons and patients alike. The reasons for this are many, and well documented in both clinical trials and clinical experience. The obvious advantages of ICL over LASIK include:
No induced dry eye: Tear film dysfunction is one of the most common frequently reported side effects of LASIK. Almost all patients report symptoms suggestive of dry eyes after the surgery, and these symptoms variably persist for up to about six to twelve months. Even though this is not a serious complication in terms of vision, it can cause symptoms like stinging, burning or scratchy sensation in the eyes, mucus discharge, sensitivity to light, redness and foreign body sensation in the eyes, blurred vision and eye strain.
Suitable for up to -20 Dioptres of myopia: The ICL is designed for the correction of near-sightedness (-0.5 to -20.0 dioptres (D) with less than or equal to 6.0 dioptres (D) of astigmatism. It is indicated for patients who are 21 to 45 years of age. ICL can be used to correct and reduce nearsightedness (myopia) of up to -20D. This means that ICL gives a safe spectacle removal option to patients with low to severe myopia, and astigmatism. Many patients with very high power of glasses (typically -8D sphere and above) are not suitable candidates for LASIK and ICL provides them with a safe and effective alternative for better sight without spectacles.
Stability of the cornea: The ICL surgery does not tamper with the stability of the cornea as no corneal flap is raised, nor is any corneal tissue removed as in LASIK. Because of the very small incision, about 3.5 mm, the procedure and recovery time is reduced dramatically. Therefore, most people are able to resume daily activities in just a few short days with clearer vision.
In addition to this, even patients with thin corneas are eligible for the procedure, unlike LASIK, in which these patients cannot be taken up for surgery. Therefore, several patients who were earlier denied spectacle removal surgery because of thin corneas can now be free of glasses.
UV protection: The collamer that is used to make the ICL is a biocompatible product that provides protection to the eye from the harmful ultraviolet rays of the sun, while allowing natural light to pass through the eye without any alteration. This is an additional advantage of the procedure which reduces the chances of developing eye conditions such as cataracts and macular degeneration, both of which have been associated with increased exposure to UV radiation.
Better night time vision: ICL provides better night time vision than LASIK with less complaints of haloes, distortions of light and sensitivity to bright light.
Reversible procedure: Very rarely, the power of glasses required for optimum vision may change after surgery also. In case this happens, or in case of the availability of new vision correction options, ICL is completely removable. This means that the doctor and the patient still retain the option of a change in ICL power, as well as that of a different surgical option. This is not possible with LASIK where the cornea is permanently altered. This allows the treating eye surgeon to make changes in accordance to changing technology as well as changing needs of their patients.Therefore, one of the important advantages of ICL is that even though it permanently corrects vision, it can be removed and/or replaced if necessary, using a very simple procedure.
Excellent Safety Profile: The ICL has an excellent safety profile documented for almost three decades. Studies have reported that the ICL provides one of the best postoperative results of all refractive procedures available in current practice. Most trials report a patient satisfaction rate of over 99%.
The obvious drawback of ICL is its higher cost, but as femtosecond laser is fast replacing regular LASIK, the difference in pricing is not very significant. Given that the ICL makes available freedom from glasses with a much better quality of life, and even to those in whom LASIK may be contraindicated, it remains a safe and cost effective option.