High myopia correction /ICL surgery (both eyes)

Last updated date: 20-Aug-2023

Originally Written in English

High myopia correction /ICL surgery (both eyes)

Overview

Myopia, commonly known as nearsightedness, is a common visual condition that is generally detected before the age of 20. Myopia impairs your long-distance vision. Near items are easy to see, whereas distance ones, such as grocery store aisle markings or traffic signs, are difficult to notice. Myopia is becoming more common.

Myopia is an extremely frequent condition. According to the American Optometric Association, over 40% of Americans are myopic, a figure that is constantly increasing, particularly among school-aged children. This tendency is expected to continue in the next decades, according to eye specialists.

Myopia is usually a mild nuisance that may be rectified with eyeglasses, contact lenses, or surgery. However, in rare situations, a progressive kind known as degenerative myopia develops, which may be extremely dangerous and is a main cause of legal blindness. Only approximately 2% of the population suffers from degenerative myopia. It is thought to be hereditary and is more frequent in Jews, Japanese, Chinese, and individuals from the Middle East.

Patients with excessive myopia or corneas that are too thin for PRK or LASIK may benefit from phakic intraocular lenses. Phakic intraocular lenses are implanted into the eye, directly in front of the native lens.

Your ophthalmologist can use an intraocular lens implant to surgically install a new lens into your eye, replacing your original one. This surgery is performed before a cataract develops.

 

What is Myopia?

Myopia

People with myopia (also known as nearsightedness) have trouble seeing distant objects yet can clearly see objects up close. A nearsighted individual, for example, may not be able to see highway signs until they are only a few feet away.

Myopia affects a large proportion of the population. It is a vision problem that can be readily rectified with eyeglasses, contact lenses, or surgery.

The majority of myopia situations are minor and may be readily treated with eyeglasses, contact lenses, or refractive surgery. In rare circumstances, though, more serious diseases arise.

High myopia, High myopia refers to a rare genetic form of high-degree nearsightedness. It occurs when your child's eyeballs develop longer than they should or when the cornea is overly steep. 

High myopia is often characterized as myopia with a refractive error higher than -6. It can evolve to higher capabilities of myopia. High myopia normally stops worsening between the ages of 20 and 30. Depending on the severity, it can be repaired using glasses or contact lenses, and in certain circumstances, refractive surgery. 

High myopia may increase your child's chance of having more significant vision problems later in life, such as cataracts, detached retinas, and glaucoma. High myopia issues can result in blindness if left untreated, thus frequent eye exams are essential.

 

Why Managing High Myopia is Important?

Managing High Myopia

Simple myopia necessitates the use of corrective lenses to restore clear vision but does not usually result in other eye issues. High myopia, on the other hand, has been linked to an increased chance of acquiring a variety of serious eye illnesses and other problems, including:

  1. Glaucoma: It is a condition that happens when the optic nerve becomes damaged and is unable to transfer visual information to the brain. If left untreated, glaucoma gradually erodes peripheral vision and eventually leads to blindness. Glaucoma-related vision loss cannot be reversed.
  2. Cataract: It's a condition that arises when the lens of the eye becomes clouded and milky, forming a veil over a person's vision and preventing them from seeing properly.
  3. Retinal detachment: It is a medical emergency that occurs when the retina rips away from the blood vessels that nourish it. Retinal detachment can potentially result in irreversible visual loss if not treated.
  4. Retinal splitting (myopic retinoschisis): It is a very uncommon condition in which the retina breaks into two layers. Retinoschisis causes gradual and progressive vision loss in different areas of a person's field of vision depending on where the split occurs.
  5. Choroidal neovascularization: It is a potentially blinding disorder that occurs when new blood vessels form beneath the retina and leak or bleed into it.
  6. Macular degeneration: It is a condition that causes central vision loss owing to macula thinning (a portion of the retina that helps you focus on objects in the middle of your field of vision). Macular degeneration can make reading, driving, and recognizing faces difficult.

Many of these disorders are connected with aging, but myopia makes them more likely to develop earlier in life. As a result, if you or someone in your family has excessive myopia, it is important to seek the advice of a skilled and experienced eye specialist.

 

Intraocular Lens Implantation

Intraocular Lens Implantation

An ICL is placed in front of the natural lens, allowing them to work together to offer high-quality vision throughout a wide range of correction. ICLs are sometimes referred to as phakic intraocular lenses (or phakic lenses). The term "phakic" refers to the fact that the lenses are implanted without removing the native lens of the eye.

The collamer phakic IOLs are constructed of a soft plastic and collagen-based biocompatible material. The implantation technique takes around 20 minutes each eye, and you'll feel an improvement in your eyesight the next day

The doctor will first place numbing drops in your eyes. The ICL will then be inserted behind the iris through a tiny incision along the side of your eye. The implanted lens replaces your natural lens. The ICL works by concentrating light that enters your eye on the rear surface of your eye (the retina). This corrects your visual problem (known as your refractive error).

 

ICL vs LASIK, Which One is Better?

LASIK refractive surgery

A frank discussion with your ophthalmologist is required when selecting between LASIK refractive surgery. Your doctor will discuss the pros and cons of each procedure for your specific scenario.

Implantable contact lenses have various benefits over laser eye surgery for improving eyesight for the right candidate:

  • ICLs provide a vision correction solution for nearsighted people who have thin corneas or other eye problems that exclude laser vision correction.
  • Because the prescription lens resides in the anterior chamber of your eye, in front of your natural lens, the ICL treatment is reversible. So, if the intended result is not attained, or if your eyesight changes over time, we can replace or remove the lenses.
  • Patients with dry eyes syndrome may experience less post-operative adverse effects following ICL surgery than after laser vision correction.
  • Because the operation to introduce ICLs does not require the removal of corneal tissue, it is less disruptive and more in tune with your natural eyes.
  • UV protection for your retinas is provided by the ICL, which is not feasible with laser vision correction.
  • ICLs offer great night vision with no halo effect around lights (which some people experience after laser vision correction).
  • With over 1 million treatments performed worldwide, ICL has a high success rate and 99 percent patient satisfaction.
  • An ICL has a lifespan of 90 years, thus the lenses are guaranteed for life.

 

Candidate for Implantable Contact Lenses

Implantable Contact Lenses

Your eye doctor will do a thorough eye exam to evaluate whether you are a good candidate for ICL surgery. Aside from anatomical prerequisites, you must also meet the following criteria to be considered for an ICL surgical procedure:

  • Be between 21 and 45 years old.
  • Have from -3 to -15 diopters of nearsightedness (myopia) and no more than 2.5 diopters of astigmatism.
  • Have written evidence that your nearsightedness prescription has been stable for at least one year.
  • Be able to lie flat on your back during the procedure.
  • Not be pregnant or nursing.

 

Disadvantages of Implantable Contact Lenses

Implantable Contact Lenses

When choosing on a medical device or operation, it's critical to consider all of the benefits and disadvantages of each option. When evaluating ICLs, keep the following considerations in mind.

Prior to your ICL surgery, you will need to have an in-office treatment. Two weeks before your ICL surgery, your eye surgeon will need to prepare your eye by using a laser to create two holes along the edge of the iris (the colored area of the eye).

Another operation to remove, replace, or modify the location of the ICL may be required. Sometimes the chosen lens can overcorrect or undercorrect your eyesight, requiring a second treatment to fine-tune the results.

An FDA long-term follow-up of the Visian ICL clinical study monitored 526 eyes for 5 to 7 years after implantation and discovered that 8.2% needed a second operation.

Cataract development is more likely (clouding in your natural lens). Every year that the ICL persists in your eye increases your chance of acquiring cataracts. As a result, you'll require annual eye exams following ICL surgery to screen for cataracts.

The good news is that if you do need cataract surgery, you can have your natural lens replaced with a prescription lens rather than a crystalline lens and your ICL removed.

In people who are extremely nearsighted, increased intraocular pressure (IOP) can develop over time. Because virtually all ICL patients are nearsighted, it stands to reason that they are more prone than others to acquire high eye pressure, placing them at risk for glaucoma. According to one research, 47 eyes (or 1.6 percent) of 2,999 with Visian ICL implants required therapy for elevated IOP or glaucoma within 5 years following ICL surgery.

For many patients, this is when the rubber hits the road. This is due to the fact that ICLs are significantly more costly than laser vision correction. There is a lot of pricing rivalry among laser vision repair practices, which helps to keep prices low. Lasers are quite expensive, and vision correction clinics must keep them working full-time to pay their expenditures, therefore they are eager to lower their prices to keep their machines busy.

 

What Does ICL Eye Surgery Involve?

ICL Eye Surgery

During the initial appointment, your eyes will be evaluated and your prescription will be verified by an optometrist. A thorough medical history will be gathered to ensure that the consultant is aware of any medical issues that may jeopardize your ability to undergo surgery. Your consultant will then be able to advise you on the best method for you and explore the many possibilities with you.

During ICL surgery, either both eyes are treated on the same day, or the second procedure is performed a week later. Prior to treatment, anesthetics and sedatives are delivered to guarantee your comfort. The ICL is then folded and placed into the eye through a small keyhole incision (2-3mm) created in the edge of the cornea. The lens implant is precisely positioned behind the iris and unfolds into place using a specific delivery mechanism.

You may suffer some transient adverse effects following the operation, such as hazy vision, sensitivity to light, eye irritation, and glare from lights in the dark.

If you are driving to your operation, you must plan for someone to transport you home on the day of your treatment. Everyone recovers at a different rate, so you should not drive until you are entirely comfortable. The recovery period for ICL is rather quick, and most patients may return to work the same day.

 

ICL Surgery Cost

The first consultation costs £195. The total cost of your subsequent treatment will be revealed once you and your consultant have decided on your personalized plan.

ICL surgery costs £3,885 for one eye or £7,140 for both eyes. This price includes your consultant's professional expenses, your individualized treatment plan, extensive diagnostic tests and checks, and two follow-up sessions for your aftercare.

There may be times when extra scans/tests are necessary that are not included in the package pricing. This is uncommon, and your consultant will discuss it with you if more testing are needed.

 

Risks & Complications

eye Infection

All surgical treatments include some risk, however the advantages of EVO Visian ICL surgery clearly exceed some of the alternatives. ICL surgery conducted by a skilled and experienced surgeon will lessen hazards. Since 2002, surgeons at the Centre for Sight have implanted this lens and have made significant efforts to ensure patients are appropriate, the lens size and power are optimized for each eye, and surgery is conducted to an excellent quality in the best possible setting.

  1. Cataract: Cataract formation is a potential risk if the implant were to damage the crystalline lens during the procedure.
  2. Infection: Infection is a possibility in every operation but very rare in EVO Visian ICL surgery. At Centre for Sight we are pleased to state we have not had a proven infection following ICL surgery.
  3. High intraocular pressure: This can happen as a result of a "steroid reaction." Some people's blood pressure may rise as a result of the steroid eye drops prescribed after surgery. This is uncommon, and patients should contact if they have a headache, eye discomfort, or vision disturbance. High pressures can arise as a result of pigment dispersion, which occurs when the iris rubs against the Implantable Contact Lens early after the treatment. In principle, this might result in increased ocular pressure due to a clog in the drainage system. Although pigment dispersion has been observed in our patients on occasion, it has not resulted in significant pressures necessitating treatment.

 

Aftercare & Recovery

Recovery after eye surgery

You must be examined the day following your surgery to check that everything is well. You will be seen again after one month for a battery of tests to verify your lenses are properly positioned and stable. You can be seen earlier if it is deemed essential or if you have any concerns. The vision is usually extremely excellent the day following ICL surgery and improves over time. The eye drops are highly powerful and might impact the eye surface, causing symptoms of dry eye and perhaps impairing vision briefly. This will improve once the drops are discontinued, however, it is critical that they are used as directed. You will also be given artificial tears to use if this occurs.

While the great majority of patients are delighted with their visual results, for a very small percentage of patients, achieving good vision can be quite a shock and differ from vision with glasses or contact lenses.

This first shift is something that all patients gradually adjust to and are happy with their visual independence. We recognize that each patient is unique and responds differently, and at Centre for Sight, we take pleasure in providing excellent care to our patients.

 

Common Inquires about ICL surgery

  • Does Health Insurance cover payment for Visian ICL surgery?

No. Visian ICL surgery is a refractive operation (similar to PRK/LASIK) that is considered a lifestyle benefit rather than a medical necessity (like for instance cataract surgery). Individual insurance plans may give a partial benefit that can save you money on the cost of the surgery in some situations, and you should check with your insurance company or employer before undergoing the treatment.

  • What will I feel during ICL surgery?

ICL surgery is conducted with powerful anesthetic eye drops, and patients experience no pain. Sedation is administered orally or intravenously to the patient, which typically alleviates any nervousness. After surgery, there may be a minor foreign body feeling while blinking, which is caused by the edge of the micro-incision and resolves fast.

  • If my vision is still not corrected, can I have ICL surgery again?

Under or overcorrection is uncommon, but if it occurs and impacts vision, further laser vision correction surgery can be performed once the eyesight has stabilized for a few months.

 

What to expect after ICL surgery?

ICL surgery Expectation

The fact that vision returns swiftly following ICL surgery is what makes the process so fascinating. We evaluate your vision and the cornea ten to fifteen minutes following the treatment to ensure everything is in order. Although hazy or foggy immediately following, this clears after a night's sleep. 

Visual recovery can take somewhat longer than one day in a few people, and can potentially take up to 10 days. Despite the fact that everyone is different, the great majority of IntraLASIK patients have a legal driving vision or better the very next day. It should be noted that eyesight may vary slightly in the first several weeks. This is a natural occurrence, and you will see that it will stabilize and improve with time.

 

Conclusion

High myopia correction

Myopia is a refractive defect or visual focusing problem. Long-distance vision is challenging because images are concentrated in front of the retina rather than on it. High myopia occurs when the visual error surpasses eight dioptres. High myopia affects around 2% of the population and increases the risk of developing certain eye problems.

ICL implantation necessitates surgery. A surgeon inserts the lens between the native lens of the eye and the colored iris. The lens works with the eye's natural lens to bend (refract) light on the retina, resulting in clearer vision.

The ICL is constructed of plastic and a kind of collagen known as collamer. It is a phakic introcular lens. The term "phakic" refers to way the lens is inserted into the eye without removing the native lens.

ICL surgery is not required to treat vision impairments, however, it can remove or lessen the need for glasses or contact lenses.