Implantable Contact Lenses (ICLs)

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Phakic intraocular lenses, also known as implantable contact lenses (ICLs), are implantable contact lenses that are surgically inserted into the eye where they provide excellent quality of vision with predictable and stable results. The Visian ICL is the latest phakic intraocular lens to receive approval from the FDA for a wide range of myopic (nearsightedness) correction needs. This technology is adapted from the proven lens technology used for cataract surgery, and works by placing the Visian ICL in front of the natural lens inside the eye. The Visian ICL is made of an advanced material that is extremely biocompatible and provides superior optical performance.

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Advantages of Phakic Intraocular Lenses

•   Able to correct high degrees of nearsightedness that cannot be corrected with other surgical procedures •   May be performed in patients who are not candidates for LASIK due to corneal irregularity or thinness
•   Less likely to cause or contribute to dry eyes
•   May be surgically removed

Frequently Asked Questions about Phakic Intraocular Lenses

Q. How do I know if I am a candidate for the Implantable Contact Lens?
A. A good candidate for an ICL is between 21 and 45 years of age and is myopic (nearsighted). It is preferable that the patient has not undergone any ophthalmic surgery and does not have a history of eye disease such as iritis, glaucoma, or diabetic retinopathy. Women who are pregnant or nursing should wait to have an ICL implanted. Those without a large enough anterior chamber depth or endothelial cell density may not be good candidates.

Q. Where is the ICL placed?
A. The ICL is surgically inserted through a small micro-incision just behind the iris in front of the eye’s natural lens. The ICL does not touch any internal eye structures and stays in place without maintenance.

Q. What is the history of the ICL?
A. The Visian ICL was approved by the FDA in December 2005, and, as of December 2006, approximately 55,000 patients have had the lens implanted. The manufacturer reports that over 99 percent of patients in clinical trial were satisfied with their implant. The lens has been available internationally for over 10 years.

Q. What is the ICL made of?
A. The Visian ICL is made of Collamer®, a highly biocompatible advanced lens material which contains a small amount of purified collagen. Collamer does not cause a reaction inside the eye and it contains an ultraviolet filter that provides protection to the eye.

Q. What if my vision changes after I receive the ICL?
A. If your vision changes dramatically after receiving the implant, your ophthalmologist can remove and replace it. If necessary, another procedure can be performed at any time. Patients can wear glasses or contact lenses as needed following treatment with the Visian ICL. The implant does not treat presbyopia (difficulty with reading in people 40 years of age and older), so some patients may need reading glasses.

Q. What happens during the surgical procedure?
A. During an office visit before surgery, your ophthalmologist will use a laser to create a small opening between the lens and the front chamber of your eye. This allows fluid to pass between the two areas, thereby avoiding the buildup of intraocular pressure following the surgery. The implantation procedure itself takes about 15 minutes and is performed on an outpatient basis, though you will have to make arrangements for someone to drive you to and from the procedure. Most patients experience very little discomfort during the ICL implantation. You will undergo treatment while under a light topical or local anesthetic, perhaps with the addition of a mild sedative. Following surgery, you may use prescription eye drops or oral medication. The day after surgery, you will return to your surgeon for a follow-up visit. You also will have follow-up visits one week, one month, and six months following the procedure. Although the ICL requires no special maintenance, you are encouraged to visit your eye doctor annually for check-ups following the procedure.

Q. Can the ICL be removed from my eye?
A. Although the ICL is intended to remain in place permanently, a certified ophthalmologist can remove the implant if necessary.

Q. Is the lens visible to others?
A. No. The ICL is positioned behind the iris (the colored part of the eye), where it is invisible to both you and observers. Only your ophthalmologist will be able to tell that vision correction has taken place.

Q. Will I be able to feel the Visian ICL once it is in place?
A. The ICL is designed to be completely unobtrusive after it is put in place. It stays in position by itself and does not interact with any of the eye’s structures.

References
Bourne et al., Invest Ophthalmol Vis Sci. Central corneal endothelial cell changes over a ten-year period. 1997;38:779-782.

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