Although laser refractive surgery (PRK and LASIK) is the most widely used alternative for surgically correcting focusing problems, a procedure known as Implantable Corrective Lens (also known as Implantable Contact Lens or Visian ICL) provides another option for people with nearsightedness, farsightedness and astigmatism. Unlike other methods of refractive surgery, which alter the shape of the cornea, the ICL does not affect the cornea's shape. The refractive principles of the Implantable Corrective Lens are well proven, they are the same as those used with glasses and contact lenses.

The procedure directly implants a lens made of biocompatible material directly behind the iris and in front of the eye's natural lens. It does not alter the patient's own crystalline lens. The surgery can be performed on an outpatient basis, immediately correcting vision problems. It promises dramatic results that are predictable through a virtually painless procedure. Prior to the ICL treatment, a preoperative Nd:YAG  laser Iridotomy is performed. This procedure creates 2 small holes in the iris to ensure that intraocular fluid does not build up behind the ICL resulting in secondary glaucoma - an eye 
pressure problem.

The ICL procedure is a relatively comfortable experience for the patient because proven and effective methods of anesthesia are used. Topical anesthesia uses eye drops to numb the surface of the eye. The patient is still able to see and move the eye during surgery and patches are not required afterward. Topical anesthesia is the most commonly used type of pain management at the Gimbel Eye Centre.

Some advantages of Implantable Corrective Lens include:

• Removable: The Implantable Corrective Lens is a removable device, where removal of the ICL will not likely permanently damage the cornea or other intraocular tissues.
• ICLs can correct low, moderate and very high levels of nearsightedness and farsightedness: Although, modern excimer laser procedures can correct nearsightedness up to 8 to 10 diopters and farsightedness up to 2 to 3 diopters, corrections are less predictable in higher ranges. In addition, people with more extreme refractive errors are not able to benefit from these laser procedures.
• No central corneal involvement: ICL implantation should not affect the cornea since the lens will be placed behind the cornea and iris, in front of the anterior surface of the natural crystalline lens. Unlike other refractive procedures performed on the cornea, the ICL does not disturb the normal aspheric configuration of the corneal refractive surface.
• Faster visual stabilization: It takes up to 3 months for vision to stabilize after an excimer laser procedure. Vision improves significantly immediately after an ICL procedure and is almost always stable within 2 weeks.
• Minimal Surgeon Learning Curve: The surgical implantation procedure suggested for the ICL does not differ greatly from placement of foldable intraocular lens during cataract surgery, which results in a minimal learning curve for surgeons performing ICL procedures.

As with any type of surgery, there are risks and advantages to an Implantable Corrective Lens. Some of the potential risks of an ICL include:

• Increased risk of retinal detachment: Nearsighted people usually have longer eyes that can result in fragile retinas, which are more prone to retinal holes or tears. Any surgery within the eye carries a risk of retinal detachment, and this risk increases as the amount of nearsightedness increases. The risk of retinal detachment is low for farsighted patients.
• Risks associated with surgery within the eye: Since an ICL is an intraocular procedure, the risks associated with cataract surgery are also relevant to ICL surgery. The following complications are extremely uncommon, but they can occur: hemorrhage within the eye; infection within the eye; induced astigmatism; swelling around the eye and increased dryness of the eye. Other complications associated with ICL procedures are reflections or slight distortions from the lens implant; an increase in the number, shape or size of floaters; potential for early cataract development; loss of corneal clarity; wound leak; pigment dispersion glaucoma and uveitis (i.e., inflammation). It is worth noting, some complications of intraocular surgery are associated with local anesthesia and are not a concern for people who have topical anesthesia. Typically, surgeons perform ICL surgery using topical anesthesia instead of local anesthesia, which uses needles.  
• Risks associated with removal of ICL: Potential complications of surgery to remove the ICL can include premature cataract formation; corneal damage; inflammation; infection leading to loss of the eye; damage to the iris as well as other 
  ocular complications.

People considering ICL surgery at Gimbel Eye Centre can be comfortable knowing that Gimbel Eye Centre surgeons have performed over 50,000 cataract procedures and are recognized as leaders in cataract surgery. Individuals considering the ICL procedure should undergo a thorough eye examination and carefully discuss all available options with an experienced eye surgeon.

For further information on this or any other topic, 
please do not hesitate to contact a Gimbel Eye Centre representative.