Have you been considering LASIK or PRK, but found out you are not a candidate due to a thin cornea or high prescription? Don't worry, there is an alternative: ICL refractive surgery. In this article, we will dive into what ICL is, how it works, who is a candidate, potential risks and what to expect during the recovery period.

What makes ICL a good fit for you?

• Are you considering surgery but have too high myopia or astigmatism? ICL upper limits are quite high for myopia and astigmatism, making it ideal for those who are not candidates for laser-based refractive surgery like LASIK or PRK. For example one brand of ICL is FDA-approved for myopia between -3.00 to -20.00 D. Their toric version can correct astigmatism in the range of 1.00 to 4.00 D.
• Unlike LASIK and PRK, which have minimum corneal thickness requirements, ICL does not impose any such limitations. As a result, ICL can still be considered an alternative for individuals with thinner corneas who are not suitable candidates for laser-based treatments.
• ICL is a good choice for those who are considering refractive surgery but have dry eye. While there is a small incision with ICL, it is not as severe as those done in laser based procedures.
• ICL is reversible!

What is ICL Refractive Surgery and How Does It Work?

ICL, also known as Interocular Contact Lens or Implantable Collamer Lens, is an FDA approved procedure that corrects a patient's prescription by placing an artificial lens in their eye. Unlike LASIK and PRK, which reshape the surface of the eye's cornea, ICL does not affect the cornea. Instead, the surgeon places the artificial lens behind the colored part of the eye (the iris) and in front of the natural lens, correcting the patient's vision without altering the cornea's shape.

ICL Refractive Surgery Candidates: Are You Eligible?

The following are some general criteria for individuals who may be good candidates for ICL refractive surgery:

• Age: Generally, candidates for ICL surgery should be between the ages of 21 and 45 years.
• Stable vision: The candidate's vision should be stable for at least six months before the surgery.
• Refractive errors: ICL surgery can correct moderate to severe nearsightedness (myopia), and sometimes mild to moderate farsightedness (hyperopia) and astigmatism.
• Healthy eyes: Candidates should not have any eye conditions or diseases such as glaucoma, cataracts, or macular degeneration that could affect the success of the surgery.
• Adequate corneal thickness: Candidates should have enough corneal thickness to undergo the surgery.

What to Expect During the Recovery Period

The recovery period for ICL refractive surgery typically lasts about a week, though individual recovery times may vary. Patients can expect minimal irritation and discomfort during the recovery period, with vision improving gradually over time.

Compared to LASIK and PRK, ICL may have a longer recovery time. LASIK patients typically experience improved vision the day after the procedure, while PRK patients may take longer to recover. However, ICL patients can expect their vision to improve significantly within a week.

Refractive Errors Corrected by ICL Surgery: Myopia, Hyperopia, and Astigmatism

The Implantable Collamer Lens (ICL) is an effective solution for a range of refractive errors, including:

• Myopia (nearsightedness): A condition where the cornea is too curved or the eye is too long, causing distant objects to appear blurry.
• Hyperopia (farsightedness): A condition where the cornea is too flat or the eye is too short, causing near objects to appear blurry.
• Astigmatism: A condition where the cornea is irregularly shaped, leading to distorted and blurry vision.

ICL surgery is primarily recommended for individuals with moderate to severe myopia, but it can also be used to correct mild to moderate hyperopia and astigmatism. The extent of correction achievable through ICL surgery depends on various factors, such as the patient's specific refractive error, corneal thickness, and eye size.

ICL Surgery Risks and Potential Complications: What Patients Should Know

ICL is a common and minimally invasive procedure that is generally well tolerated. Here are some of the potential downsides of ICL.

• Infection - As with any surgical procedure, infection is always a risk factor. Although the chances are rare, it is crucial to mention this to the patient before the surgery. The surgery center technicians clean and disinfect everything, significantly reducing the risk of infection. However, it is essential to be aware of this possibility.
• Corneal Damage - During the surgery, the surgeon inserts the lens into the eye. In some cases, the lens may tap or bump into the back part of the cornea. The cornea has water pumps that help pump out the water to prevent swelling. If the artificial lens bumps into the back part of the cornea, it can damage these pumps, leading to inflammation, swelling, and blurriness.
• Cataract Development - If the lens bumps into the natural lens that is already present in the eye, it can trigger early-onset cataracts. This complication is not common, but it is essential to mention it to the patient.
• Increased Eye Pressure - Placing the lens can increase the eye pressure, which can be prevented by the surgeon creating a small hole in the colored part of the eye before the surgery. This procedure will not be visible to the naked eye and will not cause any pain.