Visian Implantable Collamer Lens (ICL): Pros and Cons

Implantable Collamer Lenses (ICLs) are increasingly popular in the world of refractive eye surgery. Similar to the intraocular lenses (IOLs) used in cataract surgery, ICLs offer an alternative to laser vision correction surgery like laser-assisted in situ keratomileusis (LASIK surgery) or photorefractive keratectomy (PRK). Our team at the Kraff Eye Institute will explore the various pros and cons of opting for ICL as an outpatient procedure.

What Is Visian ICL?

As mentioned, Visian ICL is a type of IOL used in a specialized vision correction procedure designed to correct different vision problems. During the procedure, an eye surgeon such as Dr. Kraff implants a biocompatible Visian ICL lens behind the iris and in front of the eye's natural lens to correct vision problems. This offers a permanent yet reversible solution for refractive errors such as myopia, and astigmatism.

Comprehensive Benefits of ICL Surgery

Exploring the numerous benefits of ICL surgery can help you understand why it's gaining popularity as an alternative to other surgical methods.

#1. High Prescription Accommodation

One of the foremost ICL benefits for those wearing glasses or contact lenses is its ability to correct a wide range of prescriptions. This far exceeds the limitations of most other corrective vision procedures. Visian ICL is approved by the FDA and can correct myopia between -3.00 to -20.00 D and astigmatism between 1.00 to 4.00 D. This makes ICL an excellent choice for individuals who might not be eligible for LASIK or PRK surgeries due to their limitations regarding prescription strength.

#2. No Minimum Corneal Thickness Requirement

Unlike laser eye surgeries like LASIK or PRK, ICL does NOT require a minimum corneal thickness. This makes it a suitable option for individuals with thin or irregularly shaped corneas. This specific advantage of ICL eye surgery allows people with thinner corneas to achieve their goal of improved vision.

#3. Less Risk of Dry Eyes

Another of the benefits of ICL vision surgery is that it generally doesn't disrupt the corneal nerves which reduces the risk of dry eyes post-surgery. This is an important consideration for those who already suffer from dry eye conditions.

#4. UV Protection

One unique advantage of ICL eye surgery is the built-in ultraviolet (UV) protection it provides to the inner eye, including the macula. This feature complements the eye's natural lens but doesn't replace the need for sunglasses to protect other areas like the cornea and eyelids.

#5. Reversible Procedure

ICL implantation is reversible which offers a level of comfort and flexibility not usually associated with other, more permanent surgical vision correction procedures like LASIK. This is similar to the reversibility seen in certain types of cataract surgery where the intraocular lens can be replaced if needed.

#6. Enhanced Night Vision

ICL offers excellent visual quality, particularly for those with high prescriptions. The natural shape of the eye's cornea is maintained, which can result in better night vision compared to other vision correction methods.

#7. Biocompatibility

Implantable contact lenses are made of a specialized bio-material called Collamer, which comprises purified collagen. This ensures that the body won't reject the lens as a foreign element, making ICL a biocompatible option.

#8. Maintenance-Free

ICLs are essentially maintenance-free, they don't require daily cleaning, disinfecting, or removal. Once implanted, the lens is designed to stay in place indefinitely, eliminating the need for additional vision aids like glasses or contacts.

#9. Quick and Minimally Invasive Surgery

The implantation procedure for ICL is quick, often taking as little as seven minutes, and involves minimal downtime. Plus, the procedure's minimally invasive nature means less tissue removal and smaller incisions compared to other surgeries like LASIK.

#10. Long-Term Safety and Efficacy

With FDA approval since 2005 and over 800,000 successful procedures, ICL has established itself as a safe and effective long-term vision correction alternative. In fact, most patients experience immediate vision improvement and quick recovery times.

#11. Excellent Success Rates

The most significant advantage of ICL surgery is its ability to correct moderate to severe nearsightedness effectively. According to research, 96.7% of patients could see 20/40 or better after the first year and 94.7% could see 20/40 or better after three years without additional vision aids.

Disadvantages of ICL Surgery

While ICL surgery offers a range of benefits for vision correction, you should also consider its limitations to make an informed decision.

Limitations in Age Range

ICL is FDA-approved only for individuals between the ages of 21-45. Unlike LASIK eye surgery, which can be performed on those over 18, the age range for ICL is more restricted.

Limitations in Treatable Conditions

It's essential to know your specific refractive error before considering surgical options. ICL can correct myopia and astigmatism but for now, is not an option for those with hyperopia.

Extended Recovery Time

Although the recovery process for ICL is generally smooth, it can take slightly longer than LASIK — around a week. This recovery time frame is similar to PRK.

Implantable Contact Lens Risks

Generally, the ICL procedure goes smoothly. However, as with any surgical procedure, there's always a small risk that something could go wrong.

Risk of Endothelial Damage

During the insertion of the ICL, there's a chance it could bump the inner side of the cornea, known as the endothelium. The endothelium is responsible for pumping water into the cornea, and damage to it could lead to corneal swelling and blurry vision.

Risk of Cataract Formation

If the ICL comes into contact with the eye's natural lens while being positioned, it could lead to the formation of a cataract and cause blurry vision. In some cases, it could require surgical intervention.

Risk of Increased Intraocular Pressure

Improper placement of the ICL or an ICL that takes up too much space can elevate the intraocular pressure within the eye, posing a risk for glaucoma, which can ultimately result in vision loss.

Risk of Under- or Overcorrection

Despite sophisticated calculation algorithms, the power of the ICL might not perfectly align with the patient's needs, leading to under- or overcorrection. This may necessitate the continued use of glasses or contact lenses, although additional procedures can sometimes correct the issue.

Risk of Retinal Detachment

There's a possibility of retinal detachment, especially in patients with high levels of nearsightedness, which could result in vision loss.

Risk of Eye Infection

As with most surgical procedures, ICL surgery carries a risk of infection within the eye.

Am I a Good Candidate for ICL (Implantable Contact Lens)?

Some of the best candidates for ICL are those with high glasses/contact lens prescriptions. An ICL can offer the benefit of crisp, clear vision, free of halos and glare. Patients should be relatively young, between the ages of 21-45, since presbyopia and cataracts start to develop later in life and could impact the clarity of vision.  

Weighing implantable contact lens pros and cons is important when considering this refractive surgery option. If you're considering this procedure, talk to your doctor today about whether ICL is right for you.