ICL vs LASIK Surgery - Which one is Right for you?

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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. Before 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 centre 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 sedation.

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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 vision recovery.

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.

Difference Between LASIK Surgery 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 eye.

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 glasses prescription. 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 shape. 

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 are better for people with moderate to high nearsightedness with icl surgery compared to corneal based refractive surgery.

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 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 surgery.

There are strict screening criteria for anatomical features of the eye to ensure, there 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 developing 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.

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