Visian ICL Lenses

What is an ICL lens?

An ICL lens (Implantable Collamer Lens) is an intraocular lens positioned in the posterior chamber of the eye, between the iris and the crystalline lens. It is implanted in the sulcus and is designed to avoid causing damage to the other ocular structures.

Diagram of an Eye with a Visian ICL phakic lens implanted (https://visianinfo.com/)

 Diagram of an Eye with a Visian ICL phakic lens implanted (https://visianinfo.com/)

Who are ICL lenses for?

Candidates for this type of lenses are patients who are not affected by presbyopia and do not have cataracts; but they do suffer from myopia, hypermetropia or astigmatism. They are generally patients with a high correction or who, for some reason, cannot be operated on with another technique such as LASIK. Ideally the patient should not have had ophthalmic surgery before and should have no history of eye conditions.  Based on your visual requirements, eye health and medical history, your ophthalmologist can determine if you are a good candidate for this type of surgery.

Patients who, for any reason, need to keep their cornea intact, want a reversible operation and also to achieve perfect optical quality, are ideal candidates for an ICL lens implant.

What ICL lenses are there on the market?

Visian ICL lenses are sold by the company STAAR and are a lens type with the latest technological advances in terms of visual correction.  They are manufactured using collamer, a material made from pure collagen copolymer, which is biocompatible with the eye.   Due to its characteristics, this material transmits light in a similar way to the eye’s natural lens. It has anti-reflective properties, which means that less light is reflected in the eye to achieve  vision that is clearer, with less glare, fewer halos and improved visual quality at night.

A wide range of refractive defects can be corrected with great precision, from myopia or hypermetropia to astigmatism.

In the past, an iridotomy had to be performed to implant this ICL, in other words, the iris was perforated using a YAG laser to ensure that the exchange of aqueous humour between the anterior and posterior chambers could remain stable. Nowadays, the new aqua-flow design of ICL lens comes with a hole in its central optic to avoid having to perform the iridotomy on patients with myopia and astigmatism, and thereby achieve stable IOP (intraocular pressure) at the same time.  Only on hypermetropic patients is the iridotomy still performed as a preventive measure.

Diagram of the Visian ICL Phakic Intraocular Lens (staar.com)

Diagram of the Visian ICL Phakic Intraocular Lens (staar.com)

Another advantage of the Visian ICL lens is the protection it offers against ultraviolet rays.  Prolonged exposure to UV radiation can damage the eyes in the long term, and may cause eye problems such as cataracts or other retinal conditions such as AMD. For this reason, the material of the ICL lens contains an ultraviolet ray blocker to prevent the development of secondary eye conditions.

It is possible to implant a spherical (to treat myopia or hypermetropia) or toric (to treat astigmatism) ICL, depending on the visual requirements of each patient.

What does ICL lens surgery involve?

To implant a traditional ICL lens, your surgeon will see you one or two weeks before the operation to perform an iridotomy with a YAG laser.  This means that they make one or two small holes near the edge of the iris.  These openings allow the aqueous humour to circulate as normal around the lens which is to be implanted, to thereby maintain stable IOP (intraocular pressure).

The surgery is a quick, outpatient procedure.  The patient can return home on the day of the operation, as with cataract surgery or LASIK surgery. The anaesthetic used in this case is topical to minimize discomfort during the operation, although on some occasions a sedative can also be used.

The surgeon starts by making some corneal micro incisions.  Then, as it is a flexible lens, a special instrument is used to insert the ICL directly behind the iris and position it carefully.  The ICL unfolds gently in the eye and the surgeon then moves it into the correct position.

Due to the fact that the corneal incisions made during surgery are very small, stitches are not required in this procedure, so recovery is fast.   In all cases, drops are administered to help to prevent infections or inflammations.  This medication is also prescribed for the next few days.  It is important for the patient to avoid driving or travelling alone after the operation, and they are therefore recommended to be accompanied by a trusted acquaintance.

Finally, an ophthalmic check-up is performed within 24 hours of the operation to check that everything has gone as planned and to monitor eye health.

Steps in the implant of a Visian ICL Phakic Lens (https://staar.com)

Steps in the implant of a Visian ICL Phakic Lens (https://staar.com)

What are the advantages and disadvantages?

The refractive results after ICL lens surgery are stable and satisfactory.  The optical quality achieved with this operation is in HD (high definition) as no changes are made to the corneal tissues and as a result there are no alterations of the ocular aberrations.  When compared with the various types of refractive surgery, it can be noted that laser-treated eyes have three times more spherical aberration than those treated with ICL.

Patients can appreciate a significant change in visual quality shortly after the lens is implanted. Visual recovery is practically immediate, as are its excellent results.  The visual quality achieved with this procedure is far superior to that obtained with other correction techniques.

Comparison of the post-operative result between Lasik and Visian ICL Lens (https://visianinfo.com/)

Comparison of the post-operative result between Lasik and Visian ICL Lens (https://visianinfo.com/)

Despite the fact that it is a surgical solution which is performed with a view to the lens remaining in the eye permanently, it can be removed if necessary.  Although it is unlikely, the patient may suffer side effects following an ICL implant.  This is an advantage, as the lens can be removed without damaging the other structures of the eye.  If necessary, the first lens implanted can be replaced by another ICL lens or another type of surgery can also be performed, such as refractive lens surgery. This reversible nature of the procedure allows for any type of future intervention, provided that there are no contraindications.

One of the potential risks after implanting an ICL lens is the formation of a secondary cataract due to the proximity between the two structures. Despite the fact that this is a factor to take into account, nowadays the effect is minimal.

Patients who, for any reason, need to keep their cornea intact, want a reversible operation and also to achieve perfect optical quality, are ideal candidates for an ICL lens implant.