What Are Implantable Contact Lenses (ICLs)?

All around the world, some people have to live with vision problems. In the UK alone, it is estimated that more than two million annually will have to live with sight loss as a result of commonly different eye conditions. This estimate takes into account different factors like age, gender, weight, ethnicity, and overall lifestyle.

For many people, wanting to see clearly is more than a matter of convenience. If you are one of the millions with visual difficulties, you may find that wearing glasses or contact lenses is an absolute necessity but sometimes may not be enough. This is where implantable contact lenses (ICLs) come into the picture.

What are ICLs?

Implantable contact lens, also called phakic intraocular lens or implantable collamer lens, is made from a biocompatible material consisting of combined collagen and polymer naturally found within the body (thus explains the name collamer). It is surgically placed inside an individual’s eye – behind the iris but in front of the crystalline lens – in order to permanently correct their vision.

ICL corrects for the spherical component of the refraction in the eyes. It can be used to correct myopia from -3.00 to -20.00 diopters. An implantable collamer lens provides an alternative to reading glasses or contact lenses for those patients with severe myopia or astigmatism and are not good candidates for LASIK. ICL remains in the eye for a much longer period but it can be removed if there are improvements in the patient’s vision.

At present, thousands of implants are already completed by surgeons. The good thing about ICL is that it doesn’t cause any side effects or discomfort. If unsatisfied with the results, patients can request to have their ICLs removed.

How are ICLs different from regular lenses?

Patients have two different options when it comes to correcting their vision. If they don’t want to wear glasses or if they are not a good candidate for PRK corrective laser surgery or LASIK, then they can either wear regular contact lens or get permanent lenses installed.

Implantable Collamer Lens (ICLs) vs Regular Lens

As we mentioned above, phakic intraocular or implantable collamer lens is made from biocompatible materials. During an ICL procedure (this uses lasers to make the incision to implant the lenses), the lenses are implanted into the eye in between the cornea and the iris. Regular lenses are placed directly on the cornea by placing them on the middle finger or pad of the index finger with the concave side upward.

Regular lenses are obtained from the optometrist to correct one’s vision caused by vision problems like farsightedness, nearsightedness, astigmatism, and presbyopia.

Today, we can find several different types of lenses on the market. They include soft lenses, hard lenses, coloured lenses, toric lenses, and bifocal lenses. They can be used on a daily, weekly, or monthly basis.

The thing about regular lenses is that they bring increased risks of eye infections. Other key concerns include improper contact usage and storage and at-risk behaviours that could permanently damage one’s vision. These concerns don’t apply to implantable collamer lenses.

What are the pros of ICLs?

Implantable collamer lens (ICL) surgery is becoming more popular among patients looking to improve their vision. This is mostly owing to the fact that ICL surgery is an effective, safe, and quick procedure that offers permanent results. It only takes around fifteen minutes to get the procedure done.

Surgeons simply place a lens between a patient’s iris and crystalline lens while making sure not to damage the corneal tissue. Apart from the ease of the procedure, healing time is also very fast. A patient can go back to normal activities the very next day.

In addition to these advantages, an ICL surgery also offers the following pros:

⦁ It is one of the best vision correction alternatives, improving the quality of vision among patients. With ICL surgery, an excellent quality of vision is achieved as the eye maintains its natural corneal shape.
⦁ Corneal nerves are not disrupted in any way during the placement of ICLs. This is the reason why the procedure does not lead to dry eyes and causes no discomfort.
⦁ Since the lenses are made from collamer, a purified form of naturally occurring collagen found in the body, they do not cause rejection. This means that there is a very low chance of ICL being rejected by the body. This is because the body does not treat the lenses as foreign bodies. There is also a low chance of infections.
⦁ ICLs are very user-friendly. They do not require maintenance such as disinfecting or cleaning. They also do not need to be removed daily. Unlike regular lenses, ICLs can stay in the eye indefinitely.
⦁ ICL surgery is a very good alternative for patients who are not good candidates for LASIK surgery due to irregular corneas, large pupils, or very high prescriptions.

Many patients trust ICL surgery as it is non-invasive and takes only a few minutes. Overall, the above-mentioned pros of ICLs are the reasons why patients with vision problems opt for this procedure.

What are the cons of ICLs?

Implantable collamer lens surgery poses very low risks. However, the procedure is recommended only in patients between the age group of 18-50 years. Also, ICL surgery will probably not be included in insurance plans as it is considered to be a cosmetic procedure.

It is highly recommended that anyone who got ICL surgery done should go for regular annual check-ups.

⦁ The average cost of ICL surgery in the UK ranges from £2,495 and £3,495 per eye. It may become a costly affair for some people.
⦁ The surgery recovery time is usually within a month or two. While the recovery time is fairly short, some people may find a month or two quite long, especially if they are unable to take some time off work. However, going back to daily activities within a few days should not be an issue.

How are ICLs inserted

Prior to the procedure, numbing eye drops are administered to the patient’s eyes. The surgeon then prepares the patient’s eyes to receive the new lenses. A tiny opening in the iris is made using a laser. This is for the eye fluid to flow from the back of the eye or the posterior chamber to the front of the eye or the anterior chamber, regulating eye pressure after surgery.

There are two brands of ICLs widely used today: the Visian lens and the Verisyse lens.

Visian lens

These are lenses rolled up like a compact cigar within a pen-like device. This device inserts the lens in the eye through the clear part of the eye surface or cornea. Once inserted, the lens is then positioned behind the coloured part of the eye (otherwise known as the iris) and in front of the eye’s natural lens.

This lens option is gently unfolded within the eye where it stays in place without stitches. Stitches are not needed because the incision in the cornea is so tiny and can heal on their own.

Verisyse lens

This brand is introduced through a 6mm incision. The incision is made at the outer edge of the iris so that the lens can easily fit through it. Once the lens is in place, it is then secured using very fine dissolvable stitches. The 6mm corneal incision is also stitched closed.

The surgeon then checks the intraocular pressure before declaring the surgery done. Once everything is set, the patient is ready to be driven home by whoever is accompanying them. They will be sent home with detailed written instructions for their post-op eye care.

Are the two ICL options Visian and Verisyse the same?

At this point, you must be wondering which ICL option is better: Visian or Verisyse. Both brands of implantable collamer lenses have distinct characteristics that make them equally the best option for certain conditions. Visian and Verisyse lenses offer built-in ultraviolet filters, protecting the eyes from harmful UV rays.

The two brands also offer special ICLs called Toric ICLs, which are specifically designed for people with astigmatism. Patients who have a cornea that’s more football-shaped than round can get this type of lens. Toric ICLs lessen the blurry vision caused by astigmatism. After these lenses are inserted into the patient’s eyes, the patient won’t need to wear glasses.

What’s with Visian ICLs?

Visian ICLs have long been used ever since they were approved in 2005. Over a million eyes worldwide have achieved excellent vision thanks to these lenses. Of the patients who got this brand, over 94 percent in clinical trials reported excellent or good vision quality.

Made of a thin pliable material called collamer, the rejection risk of Visian ICLs is nearly zero. We have previously mentioned that collagen is naturally found in the body, so collamer is not recognized as a foreign object. Patients who choose Visian ICLs won’t experience any discomfort or irritations. In a survey, 98 per cent of patients said they would undergo Visian ICL surgery again if given the choice.

What’s with Verisyse ICLs?

Verisyse ICL is different from Visian in that it is not made of collamer. It is actually made of a rigid plastic material called polymethyl methacrylate or PMMA.

It’s also different from Visian ICL in a way that Verisyse ICL is placed in front of the iris or the coloured part of the eye. This allows Verisyse ICLs to be easily swapped out if a patient’s vision changes over time.

Are there ICL surgery risks one should be aware of?

While ICLs have been available worldwide for about two decades and placed in nearly one million eyes, they are still widely studied, along with the ICL surgery risks. And while the likelihood of a complication is very small, patients should still be aware of these risks when considering ICL surgery:

⦁ Acceleration of normal corneal ageing (this causes it to become cloudy)
⦁ Cataracts can occur in one percent of patients after seven years from their ICL surgery (Older patients with high degrees of near-sightedness are at a higher risk)
⦁ Eye infection or endophthalmitis
⦁ Glaucoma (lens insertion can cause the release of pigment from the iris, clogging the eye’s drainage system and increasing eye pressure)
⦁ Retinal detachment

What can a patient expect after an ICL surgery?

It merits repeating that ICL surgery is non-invasive and does not really produce irritations. In some cases, a patient might experience mild discomfort after surgery and feel irritation as though there’s something in their eyes. However, this feeling will quickly disappear. Then the patient will not be able to feel their lens nor will their lens be visible to an outside observer looking at them.

Doctors will generally prescribe medications for pain and eye drops to prevent inflammation and infection. Patients will also be given eye shields to wear at night for the first week following surgery. This is to keep them from inadvertently scratching their eyes during sleep.

How long until patients experience the result?

Most patients report getting clear vision the day after their ICL surgery. Also, most patients’ vision gets quite stabilised just within one week of surgery. Patients just have to return to the clinic on the day after their ICL surgery for a post-op eye exam.

Then, they will have to return for check-ups at one month, two months, and six months post-op for doctors to check their progress. Amazingly, patients can resume to normal activities within a few days after surgery. They will be completely healed within one month.

How should patients choose the ICL option for their condition?

The thing with ICLs is that no one type of ICL will work for everyone. Of course, everyone has different eye conditions. Thus, the appropriate ICL option will be determined by the eye doctor following a detailed eye exam using specialised equipment to measure a patient’s vision deficits and the shape of their eye.

The exam will also be conducted to identify any irregularities on the surface of the patient’s eye. This is to ensure the most precise vision correction and lens fit.

Improve your vision with ICL Surgery at Sussex Eye Laser Clinic

Implantable contact lenses have changed the lives of many. It may change yours, too. While ICL is not for everyone, we suggest you schedule an appointment at our clinic so we can check which corrective vision procedure works best for you.