In today’s article, I would like to talk to you about the lesser-known type
of refractive surgery icl surgery to help you have a better
understanding of your options when considering refractive surgery.
You probably have already heard about Lasik surgery for correcting
nearsightedness and astigmatism to eliminate glasses, and contact lenses however not many of us have heard about icl surgery as
a refractive surgery option. What is icl surgery? how does it work? Are
there risks with icl surgery? we are going to cover all of those questions
in today’s post.
Icl stands for implantable Collamer lens also called implantable
contact lens. An icl lens is made out of a
bio-compatible Collamer material that sits inside of the eye without
altering the shape or the anatomy of the eye.
ICL surgery is a surgical
procedure to implant an icl lens inside of the eye to correct both
nearsightedness as well as astigmatism. In the U.S the type of icl lens
available is called the visian icl lens. The visian icl lens received
FDA approval in 2005 and the stigmas and correction version of
visiting icl lens was approved by FDA in 2018.
By 2019 over a million
visian icl lenses have
been implanted all across the world. So there is sufficient data to prove
both the safety and efficacy of icl surgery. icl surgery is done similarly
to Lasik surgery as an outpatient procedure and it typically takes
about 15 to 20 minutes for the surgical portion of the procedure.
the icl procedure, your surgeon may perform a laser procedure to place two
small openings in the iris prior to the icl surgery and after the
procedure, you go home the same day and do not need to stay overnight in
the surgery center in the U.S. Most icl surgeons perform
bilateral surgery on the same day during the surgery you typically
receive conscious sedation through oral sedatives or iv
The icl surgery itself is painless
and after surgery, you typically will be on different kinds of eye drops
for a couple of weeks to a month depending on your personal needs and
surgeons preferences vision improvement after icl surgery is fairly quick.
You will notice improvement of your vision without glasses
shortly after the icl surgery procedure and you can potentially have a
small amount of vision fluctuation
in the following days or weeks. It rarely takes more than a month for full
You are probably thinking is both Lasik surgery and icl surgery
are vision correction surgery options to correct near sickness and
astigmatism. How do you choose one versus the other and which one
is the right procedure for you? Let’s go over the differences between
those two LASIK and icl surgery procedures.
and ICL Surgery
Both Lasik and icl surgeries were being performed starting in the early 1990s in the U.S. Lasik surgery is the cornea base laser
vision correction surgery. The procedure is performed on the surface of the
eye on the structure called the cornea. Which is a clear
dome-shaped structure that functions as a windshield of our
I performed all laser Lasik surgery for my patients during the procedure
two types of lasers are used first The femtosecond laser creates a thin corneal flap and the
flap I lifted then the excimer laser ablates cornea tissue to alter
the shape of the cornea in order to correct our vision by correcting our
After the excimer laser ablation, the cornea flap is
placed back down the amount of tissue ablation and the shape change of a
cornea is proportional to
the strength of the glasses prescription therefore the higher our glasses
prescription the more tissue of the cornea will be ablated altering the
shape of our cornea more.
icl surgery is an intraocular surgery that does not affect the
cornea. icl surgery corrects vision by implanting an icl lens inside of the
eye. The implant sits behind the iris which is the color part of our eye and
in front of our natural lens because the icl procedure does not alter the
cornea. It is a great option for people who are not laser candidates due to
different corneal conditions.
As I mentioned before the amount of tissue ablation during Lasik
surgery is proportional to the glasses prescription. Therefore people
who have moderate to high nearsightedness may have a cornea that’s
too thin to qualify for Lasik surgery or other types of
cornea-based laser vision correction also for patients or people who
have significant dry disease prior to refractive surgery.
They can also be a
good candidate for icl surgery instead of LASIK because icl surgery does not
involve any corneal tissue ablation that will change the corneal
It does not affect the natural sensitivity of the cornea. The dry disease
is less of a concern when choosing icl surgery lastly for people with
moderate to high nearsightedness large amount of corner tissue removal
during LASIK surgery can potentially affect the quality of vision after
surgery due to a large amount of corneal shape change.
icl surgery does not involve any shape change or tissue removal at the time
of surgery and many studies have shown the quality of vision and
night vision is better for people with moderate to high
nearsightedness with icl surgery compared to corneal-based refractive
The other difference between Lasik surgery and icl surgery is that Lasik
surgery is a permanent procedure that alters the shape of the cornea and can
be enhanced with additional procedures if needed while icl surgery is be reversible as icl lens is removable if desired at a later time. Now
we have learned how icl surgery differs from Lasik surgery.
It is important to remember that icl surgery is not for everyone because it
is an intraocular procedure which means we enter into the eye at the time of
the surgery and more precautions need to be taken to reduce risks of
infection during surgery.
Also, there are more tests and steps needed prior
to icl procedure to avoid any short-term pressure spike of the
eye after icl surgery because the icl lens is placed in the eye during icl
There are strict screening criteria for
anatomical features of the eye to ensure, it is sufficient in the
front part of the eye called anterior chamber to allow safe icl
implantation. Therefore people who have very crowded structures at the front
part of their eyes, as well as people who have anatomical features that
increase the risk of
develop glaucoma by
obstructing the fluid flow inside of the eye, are not good
candidates for icl surgery.
Therefore the choice of which type of refractive surgery is right for you
really depends on your glasses prescription and the anatomy of your eye as
well as your occupation and lifestyle. It is important to remember icl
surgery just like any other eye surgery It has specific risks. So it
is very important for you to discuss with your eye surgeon about your case
and come up with a surgical plan together to choose the type of refractive
surgery that is right for you.