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Implantable Contact Lenses

“I never wore glasses except when I had to read a teleprompter at an awards show or drive, so I didn't notice much. I could exist in my head. It was kind of my escape from the world and my protection.”

Nicole Kidman

 

Not everyone is as lucky as Nicole Kidman (who later underwent Lasik). Some of us become as blind as a bat without our glasses or contact lenses. Though Laser Eye Surgery is an easy and fast way to get rid of one’s glasses, not everybody is a candidate for Lasik. Implantable Contact Lenses are another option.

 

What are Implantable Contact Lenses?

Implantable Contact Lenses, also called Phakic IOLs (or Phakic intra ocular lenses) are lenses which are surgically placed in front of the natural lens of the eye. They work just like contact lenses or glasses – by bending rays of light on to the back of the eye, the retina. The only difference is that instead of sitting on your eye like the usual contact lenses, these implantable contact lenses are placed inside your eye.

 

What is ICL Surgery?

ICL surgery involves the placing of a phakic IOL. There are two types of phakic IOLs available:

               

 

The first type (see image on the left) is a non-foldable intraocular contact lens which is attached to the front of the iris. This type requires tiny stitches which dissolve easily.

The second type (see image on the right) is a foldable lens which requires a tiny cut (about half the cut as compared to the first type). Here the ICL is placed behind the iris and in front of the natural lens. Once inside, the contact lens unfolds to its entire width. This does not usually require any stitches.

 

When is ICL surgery performed? (Indications)

  • Near sightedness (especially indicated for those with large numbers like -20 D who may be left with small numbers even after lasik)
  • Far Sightedness
  • Astigmatism (Cylinder Power)

To be eligible for Phakic IOL surgery, you should be above 18, should have had stable numbers for the past year, should have healthy eyes (no cataract, glaucoma or infections) and should undergo a detailed eye check especially the depth of the front chamber of your eye as well as the health of the endothelial layer of your cornea.

 

What are the complications of ICL surgery?

The non-foldable lens requires a larger cut and is situated closer to the inner surface of your cornea. This poses a slightly higher risk of damage to your cornea.

As for the foldable lens, as it is placed close to the natural lens, a small percentage of people can develop cataract. However, recent lenses have been modified to reduce the chance of developing cataract.

Other possible risks include glaucoma from raised eye pressure, detachment of the layer at the back of the eye - the retina, infection and swelling of the cornea.

 

How do I prepare for ICL surgery?

If you are a contact lens user, you should stop wearing your contact lenses at least a week before your consultation. Contact lenses change your corneal shape and this can cause your refractive error (spectacle number) readings to be less accurate.

A week or two before your ICL eye surgery, your eye specialist may do a laser iridotomy to prepare your eye for implanting the lens. A laser iridotomy makes a small opening at the outer border of the coloured part of the coloured part of your eye, the iris. This helps the fluid in your eye circulate evenly and prevents a rise in eye pressure after phakic IOL eye surgery.

 

How is ICL surgery performed?

Eye drops are applied to numb your eyes. Your eyelids are kept open using an instrument called a lid speculum. A tiny cut (about 6 mm) is then made in the outer transparent membrane of your eye, the cornea.

 

 

The entire procedure takes between 10 – 15 minutes.

Anti-biotic and Anti-inflammatory eye drops are prescribed after the eye surgery.

 

What can I expect after ICL eye surgery?

Most people notice an improvement in their vision immediately after the eye surgery, but you can expect your vision to be blurred for the first few days. Every body’s rate of healing can vary and some might even take up to 2 – 4 weeks to achieve stable vision. A mild scratchy feeling or mild discomfort in the eye is also commonly experienced for some time.

 

What are the precautions to be taken after ICL surgery?

Until your eye has healed,

  • Do not rub or squeeze your eyes
  • Avoid lifting heavy objects
  • Do not participate in strenuous activities

You can resume work and driving within a couple of days, once your eye doctor gives you the go-ahead after the eye surgery.