ICL/Artiflec lens implantation surgery

Overview

With so many options and factors surrounding vision correction, determining what is actually the best option for you can be challenging. While LASIK is the most well-known procedure for enhancing vision through surgery, it may or may not be right for you and your eyes.

ICL surgery, which effectively provides a lens implant as a no-maintenance and permanent approach to enhancing your eyesight, has grown in popularity over the years.

A Visian ICL (also known as an Implantable Collamer® Lens) is implanted just below the iris, between the eye's normal lens and colored iris, during ICL surgery. The goal of this surgery is to change the focusing ability of the eye and eliminate the need for eyeglasses or contact lenses. In most cases, an ICL surgery is used to cure moderate to severe myopia (nearsightedness) and/or astigmatism.

ICLs work in conjunction with the eye's natural lens to bend (refract) light on the retina, resulting in better vision correction. ICL is made of plastic and purified collagen (which also naturally occurs in your body). This implant is biocompatible, soft, and flexible, and it also protects against UV radiation. Because ICLs provide a similar function to standard contact lenses, they are also referred to as "implantable contact lenses" or "permanent contact lenses."

An ICL is classified as a Phakic lens, which means that the normal lens of the eye stays intact alongside the implant. This is distinct from an intraocular lens (IOL), which replaces an eye's natural, defective lens, which may have been removed during cataract surgery.

Who is a Good Candidate?

For patients who are too nearsighted for LASIK or PRK, an ICL is a viable choice (photorefractive keratectomy). If your cornea is too thin or unevenly shaped for laser eye surgery, ICL may be an option for you as well. A few crucial features distinguish a suitable candidate for ICL surgery:

You are between 21 and 45 years old.
You have nearsighted vision with mild to severe myopia (-3D to -20D).
You have not had a change in prescription of more than 0.5D in the past year.
You are looking for a procedure that doesn’t create dry eye syndrome.
You should have enough endothelial cell density and adequate anterior chamber depth for safe implementation of the procedure.

Before undergoing any eye surgery, it is critical to consult with an experienced ophthalmologist about your best treatment choices. You should be able to decide the best practical solutions for vision correction together, taking into consideration your vision impairments, astigmatism, other eye diseases, and lifestyle requirements.

Contraindications & Precautions

ICL surgery isn’t safe for everyone. When considering the procedure, talk to a doctor to determine if it’s right for you.

The surgery may not be a good choice if you:

are pregnant or breastfeeding.
are younger than 21 years old.
are 45 and older.
have a chronic disease that causes hormone fluctuations.
are taking medicine associated with vision changes.
have a condition that inhibits proper wound healing.
don’t meet the minimum requirements for endothelial cell count.

Other measures must be taken prior to the procedure. For example, you must abstain from wearing contact lenses in the weeks preceding the operation.

Your doctor can advise you on the appropriate safety precautions to take in your specific scenario.

Artiflec VS Artisan lenses

When compared to excimer laser techniques, phakic intraocular lens (pIOL) implantation has been shown to be a safer technique for correcting myopia ranging from 6.00D to 20.00D, with significant advantages in maintaining best corrected visual acuity (BCVA), contrast sensitivity (CS), biomechanical stability, and visual effects. Artisan and Artiflex lenses, which were developed to give high safety and efficacy, have been widely used since they were introduced into the market.

Both are implanted at the same region and are fixed to the iris tissue directly, however they differ in material qualities and surgical incision size. Because of the polymethylmethacrylate (PMMA) substance, the artisan lense needs be introduced through a 6.2-mm incision. Artiflex, unlike the rigid version, is a foldable lense that requires just a 3.2-mm corneal incision to be inserted during the surgical process, even without sutures, perhaps providing a lower incidence of medically caused astigmatism.

A number of clinical trials comparing Artisan and Artiflex PIOLs for moderate to severe myopia have been done to date. Both procedures were safe and effective for myopia therapy, and when compared to Artisan PIOL, Artiflex PIOL had considerable improvements in effectiveness, predictability, contrast sensitivity, and HOA, with the exception of safety and complications, in the treatment of moderate to high myopia.

Lens Implants vs Lasik

One of the more recent advances in Refractive Surgery is the insertion of a specific lens into the eye to correct a person's eyesight. This treatment employs an Implantable Collamer Lens (ICL), and it is gaining popularity among patients looking for alternatives to glasses and contact lenses. With this technological and surgical process advancement, the area of refractive surgery has effectively expanded once again, and more people than ever before are now able to receive some form of vision correction to enhance their eyesight.

While having additional alternatives for patients is helpful. Having too many alternatives might make decision-making more challenging. We hope that this article will help you understand the differences between ICLs and LASIK surgery.

The quantity and kind of eyeglass prescription that may be addressed with either surgery is one of the most important variations between LASIK and ICLs. In the United States, the FDA has authorized ICLs to treat a wide spectrum of nearsightedness, from mild (-3.00D) to severe (-4.00D) (-20.00D). ICLs are not yet approved by the FDA to treat astigmatism or farsightedness.

LASIK, on the other hand, is approved by the FDA. It is authorized to cure farsightedness and nearsightedness with or without astigmatism, but not as much nearsightedness as ICLs (-14.00D is the top of the nearsightedness range approved by the FDA).

Two of the most significant aspects to consider when choosing ICL surgery as an alternative to LASIK are your existing eyeglass prescription and what is in your best interest from a safety viewpoint. Because ICL is a more intrusive surgery than LASIK, most doctors feel that it should be reserved for individuals who are not LASIK candidates. A patient should consult with a skilled doctor to assess their personal circumstances and discuss the risks and advantages.

ICL surgery involves inserting a tiny collamer lens, smaller than a contact lens, into the eye in front of the natural "crystalline" lens inside the eye. Depending on the ICL utilized by the surgeon, the small lens is either implanted immediately in front of or behind the iris (colored region of the eye). The surgeon will additionally make a tiny hole in the iris prior to or during the ICL operation to allow for fluid circulation inside the front part of the eye, as the implanted lens restricts the normal passage of fluid via the pupil.

Recovery from ICL surgery is relatively quick, both in terms of visual recovery and patient comfort. The lens is intended to be a permanent placement, and the lens is not intended to require cleaning, adjustment, or maintenance like contact lenses require.

Specific Consequences Happen With ICL

The key distinction between ICL surgery and LASIK surgery is that ICL surgery has a higher risk of serious infection than LASIK surgery. This is due to the fact that the surgeon must enter the eye to insert the ICL, whereas the LASIK surgery is conducted on the cornea without entering the eye.

Aside from the danger of intraocular infection, four particular problems can develop with ICL surgery:

The patient's Crystalline Lens may be bumped, perhaps leading to the formation of a traumatic cataract. If a cataract develops as a result of this, the crystalline lens inside the eye is removed (cataract surgery). Regardless of age, most people who have cataract surgery require glasses to view objects up close.

The endothelium, or back side of the cornea, can be bumped and injured. The endothelium is a one-cell-thick layer of the cornea that performs a critical regulatory function in corneal health by controlling the water content within the cornea. When the endothelial layer of the cornea is injured, it can cause swelling and cloudy, fluctuating vision.

During insertion, the iris can be bumped and injured, potentially resulting in uneven iris shape and enhanced sensitivity to light.

In a healthy eye, there is a natural flow of fluid through the pupil, and because the ICL intentionally covers the pupil, that fluid flow may be blocked. The standard of care for ICL surgery is to use a laser to create a small hole in the iris's perimeter to allow fluid flow to continue following ICL surgery. When the normal flow of fluid inside the eye is disturbed, the pressure inside the eye rises, potentially leading to glaucoma.

When deciding whether to conduct ICL surgery versus LASIK on a patient, most surgeons prefer LASIK since it does not entail the intraocular risks associated with ICL surgery. Of course, there are times when ICL surgery is the best therapy choice for the patient. Most Vision Correction Specialist Surgeons agree that ICL surgery is indicated if the patient is not a good candidate for LASIK, has the appropriate ocular anatomy to be a good candidate for ICL surgery, is dissatisfied with their current methods of vision correction, and accepts the risks associated with ICL surgery.

Some people are not candidates for LASIK but can undergo ICL surgery, hence ICLs have extended the number of patients who can benefit from Refractive Surgery. However, LASIK will most certainly continue to be the most popular and cost-effective choice for people looking to lessen or remove their dependence on glasses or contact lenses.

Benefits of Having an ICL

An ICL has various advantages in addition to enhanced vision:

It can rectify extreme nearsightedness that other operations cannot address.
If your eyes are consistently dry, the lens is less likely to produce dryness.
It is intended to be permanent, yet it is removable.
The lens has excellent night vision.
Because no tissue is removed, recovery is typically swift.
People who are unable to undergo laser eye surgery may be suitable candidates for ICL.

What to Expect During and After ICL Surgery?

A laser peripheral iridotomy will be done in the weeks leading up to your ICL surgery. Two micro-holes are created in the perimeter of the iris during this pre-op procedure to guarantee appropriate fluid flow once the ICL is implanted. Because your doctor will use numbing drops before to the surgery, this is a painless remedy.

When you come for your official ICL procedure, you will be given eye drops to dilate and anesthetize your pupils. Corneal tissue is never removed during the ICL surgery. The ICL will be folded and inserted by your doctor through a tiny 3mm incision at the base of your cornea. The ICL will be adjusted by the doctor once it is put behind the iris to ensure adequate location within the eye for best vision correction. Because this incision is so tiny, it usually heals on its own and no stitches are necessary following the procedure.

Many people will notice an improvement in their vision almost immediately after the treatment. Following the surgery, you will be given aftercare instructions and extra eye drops to clean your eyes and prevent infection. You will need to have someone drive you home following the session until your vision adapts and the effects of any sedatives provided fade out.

Your eyes and eyesight will improve over the following two to three days as they heal after the surgery, and a follow-up checkup will evaluate your eyes and provide an educated suggestion on your ICL recovery time and process. In many situations, the eye will mend and return to normal function within the first 24 hours of operation.

Is ICL Surgery Safe?

Yes. ICL surgery is a safe and reliable method that employs rigorous safety precautions both before and after your surgery. The first ICL was implanted in 1993, and over 1 million ICLs have been put since then. The hazards associated with ICL are minimal because it does not impair the structural integrity of the eye or change its shape. According to certain research, ICL may be a safer and more effective option to LASIK for individuals with low myopia.

A full pre-op eye exam will be performed before to your scheduled surgery date to acquire measurements and examine the particular characteristics of your eye to assist guarantee a successful treatment.

Is ICL Surgery Painful?

No. ICL eye surgery takes less than 30 minutes and is a relatively painless outpatient surgical procedure. You will most likely be given a little sedative before surgery, as well as a local anesthetic to numb your eye and block any potential pain.

How Long Does Lens Implant Last?

The goal of ICL surgery is for it to be permanent, providing you with a long-term vision solution that can replace (or reduce your dependency on) traditional contact lenses and eyeglasses. If you have any negative side effects from ICL, the operation may usually be reversed without causing structural harm to the eye. The following are some of the possible side effects that may need the removal or modification of the ICL:

Over and under correction
Glares or halos
Eye pressure increase (which usually normalizes with time)
Eye infection or inflammation

Another reason to remove an ICL is if your eyesight changes with time, in which case it can be replaced by a higher-powered ICL. While the simplicity of removing the ICL is an extra benefit of the process and is usually regarded as safe, there are inherent dangers with any surgery.

Cataracts develop naturally as the eye matures. When a cataract has formed. The ICL will be removed along with the cataract. An IOL (intraocular lens) will be implanted at this time to correct the eyesight once more.

ICL risks

Though ICL surgery has been shown to be safe, it may cause complications such as:

Glaucoma. If your ICL is large or improperly positioned, it might cause increased pressure in your eye. This can result in glaucoma.
Loss of vision. If you have high eye pressure for an extended period of time, you may risk visual loss.
Early cataracts. An ICL can reduce fluid circulation in your eye, increasing your risk of cataracts. This may also occur if the ICL is not adequately sized or produces persistent inflammation.
Blurry vision. Blurry vision is a symptom of cataracts and glaucoma. You might also have other visual problems, like glare or double vision, if the lens isn’t the right size.
Cloudy cornea. Endothelial cells in your cornea are reduced by eye surgery and aging. If the cells die too quickly, you may acquire a hazy cornea and visual loss.
Retinal detachment. Eye surgery also raises the possibility of your retina separating from its normal location. It's an uncommon complication that need immediate medical intervention.
Infection of the eyes. This is also a rare side effect. It can cause irreversible eyesight loss.
Additional surgery. You may need another surgery to remove the lens and correct related issues.

Lens Implant Surgery Cost

ICL is often less cheap than LASIK, costing roughly $4,000 per eye. Because this is an optional surgery, your insurance provider is unlikely to cover the cost. While this is an expensive operation, it is vital to consider it a long-term investment.

Heart of Texas Eye Institute offers a variety of cheap monthly payment plans and 0% financing alternatives to help make your goal of clear vision a reality.

Conclusion

ICL surgery (also known as Implantable Collamer or Implantable Contact Lens surgery) is a non-surgical alternative to Lasik. During the process, an eye specialist permanently inserts contact lenses into your eyes.

The degree of your nearsightedness impacts your treatment options. Minor refractive issues may usually be corrected with glasses or contact lenses. However, you may not be a candidate for Lasik surgery. ICL fills in the gaps or assists persons who choose not to use glasses or contact lenses.

The ICL technique has several advantages. Aside from increased vision, other advantages include the ability to treat extreme near-sightedness that other operations cannot repair. There is no need to use glasses or contact lenses. Permanent, yet removable if necessary enhanced night vision, Quick recuperation, Dry eyes are less prone to occur.

Yes, for the most part. The lenses can be removed, although doing so necessitates further surgery. If you choose to have your lenses removed after ICL surgery, your vision may be poorer than it was before the procedure. This is due to the fact that eyesight may require extra correction over time.

The fact that this procedure is also reversible and can adapt to any changes in vision is another key benefit of ICL, as well as the quick recovery process.