ICL surgery: an implantable lens for vision correction
An implantable collamer lens (ICL) is a thin, soft lens placed inside the eye, between the iris (the coloured part) and the natural lens, to correct short-sightedness, and in some designs astigmatism. Unlike laser vision correction, it adds a lens rather than reshaping the cornea. The natural lens stays in place, and the lens is designed to be removable.
Who might consider an ICL?
- People with moderate to high short-sightedness, or astigmatism, outside the range suited to laser
- People with thin corneas, or corneal shapes that make laser unwise
- People with dry eyes who may do better avoiding corneal laser treatment
- Adults who are typically between about 21 and 45, with a stable prescription and healthy eyes
An ICL is not suitable for everyone. It requires adequate space inside the front of the eye, a healthy corneal lining (endothelium) with enough cells, and no significant glaucoma or other relevant eye disease. Detailed scans are used to check this.
How the procedure works
- Surgery is usually done as a day procedure, one eye at a time, often a few days apart.
- A very small incision is made at the edge of the cornea, the folded lens is inserted and positioned behind the iris, and no stitches are usually needed.
- Most people go home the same day and use drops for a few weeks.
- Vision commonly improves quickly, within a day or two for many people.
What has changed
Earlier ICL designs needed a small laser opening made in the iris beforehand to let eye fluid circulate. Newer designs include a small central hole in the lens itself, which allows fluid to flow without a separate iris opening. This simplifies the procedure. Lens sizing has also improved with better imaging of the inside of the eye, which helps reduce the chance of a poorly fitting lens. Newer designs aimed at a broader range of prescriptions continue to be developed, and availability in Australia differs between models. Dr Abell offers standard and toric ICLs and can discuss the specific ICL suitable to your eyes.
ICL or laser?
Both are well-established. Laser is often chosen when the prescription and cornea suit it. An ICL may be preferred for higher prescriptions or thinner corneas. The best choice depends on your measurements, and some people are suitable for both.
Risks
Risks include infection, inflammation, raised eye pressure, cataract formation, loss of corneal lining cells, lens rotation or repositioning needing a further procedure, glare or halos, and, rarely, loss of vision. Regular check-ups are needed for life. After about age 40 reading glasses are still likely to be needed.
This article is general information and is not a substitute for individual medical advice. All surgical and invasive procedures carry risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.
