Implantable contact lenses (ICL's)
What is an ICL?
The Implantable Contact Lens (ICL) is a synthetic lens that can remain permanently inside the eye correcting vision. It is also referred to as a Phakic Intra-ocular lens. It is placed behind the iris and invisible to the naked eye.
What does the ICL procedure involve?
The ICL procedure is similar to cataract surgery. However, with cataract surgery, the eye's natural lens is removed. With an ICL, the structure of the eye remains unchanged. The implantable contact lens is inserted through a tiny incision and positioned in place just behind the iris (the coloured part of the eye), in front of the natural lens. The whole procedure takes about 15 minutes and the results can be immediate. We will not operate on both eyes in the same session as an added precaution against infection. Generally we recommend waiting 1-2 weeks before the second implant.
As a precaution against the rare risk of glaucoma two micro holes are placed in the iris, either before surgery using a Yag laser (laser iridotomy), or at the time of surgery (surgical iridotomy). This is a painless procedure. 
Once in place the ICL works in the same way as a regular contact lens.
What are the advantages of ICLs?
- They are removable so the procedure can be reversed.
- They can be used in people with a thin cornea.
- Suitable also for dry eyes.
- Even suitable for high prescriptions including astigmatism.
- No induced higher-order aberrations (this means less risk of glare, haloes or problems with low lighting which can result from high laser treatments).
- The procedure does not permanently change the structure of the eye.
- No structural change means that the focussing ability of the eye is preserved in young patients.
- There is no ongoing maintenance of the lens.
- It is an outpatient procedure performed using anaesthetic eye drops.
- There is minimal post-operative pain.
And the disadvantages?
As with any surgery there are risks, including complications due to infection. We reduce these risks by operating in the state of the art ophthalmic theatre in our clinic. As well our surgical staff are highly experienced in intra-ocular surgical techniques.
There is a slight long-term risk of inducing a premature cataract. Cataracts are a natural part of aging so cannot be avoided, even without an ICL, but to reduce the risk of a cataract developing prematurely it is advisable to choose an experienced and competent Eye Surgeon.
Who is suitable for an ICL?
We have found the STAAR ICL to be most successful in patients with severe short-sightedness (myopia). For mild myopia, laser vision correction may be more suitable. There are also some ICLs suitable for long-sighted patients.
As with all refractive surgery, each patient must have had a stable prescription for at least 12 months. They must have good general eye health and be over 21 years of age. And, they must have a genuine desire to be rid of glasses or contact lenses. As with all surgery, there are some risks and these need to balanced against your desire to be free from glasses or contacts. These risks can be discussed in detail with your surgeon during your consultation.
Are all ICL's the same?
No. ICL's are individually selected and based on detailed measurements of each eye. This includes refraction, corneal thickness, diameter and length if the eye.
Will the ICL eliminate the need for glasses?
Not necessarily. Some patients may have a residual refractive error which may mean glasses for certain situations such as reading or driving. This is still seen as a significant improvement on the extremely high refractive error prior to surgery. Also, as we age and the natural lens becomes less able to focus, many people in their 40s and 50s find themselves needing reading glasses or bifocals for the first time in their lives. This age-related affect remains in ICL recipients so as the natural lens works in tandem with the ICL, the deterioration of the natural lens will affect your vision long term. If a residual refractive error remains an issue, a laser treatment can be performed to 'fine-tune' this.
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