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ICLs are like implantable contact lenses that improve visual acuity, or eyesight, for people who have myopia, astigmatism, or both.
Although this is a rarely performed procedure, many adults with stable refractive errors can benefit from ICLs, especially if they are not good candidates for LASIK for certain reasons. Clinical studies have also shown this implantable lens option is a safe, effective procedure to improve vision.
The Visian ICL surgery is like LASIK or other refractive surgeries, although it is slightly more invasive, requires a few more steps in the weeks leading up to it, and takes about 10 minutes longer in the operating room. As with every surgery, there are some risks to Visian ICL surgery, and it costs a bit more than a procedure like LASIK.
Visian ICLs can be replaced if needed, and the surgery comes with the potential for few long-term side effects.
Visian Implantable Collamer Lenses (ICLs): An Alternative to LASIK
Visian Implantable Collamer Lenses (ICLs) are like permanent contact lenses. These miniscule devices improve vision for people with myopia, or nearsightedness. They are new synthetic lenses that can improve your vision enough, so you use glasses or contact lenses much less often, if at all.
Myopia is the most common vision problem in the world, and its prevalence appears to be on the rise. A 2016 study using data from the American Academy of Ophthalmology (AAO) reported that 9.6 million adults in the United States alone are severely myopic. About 820,000 of those adults have a degenerative form of nearsightedness. The study also found that the percent of the population with myopia has risen — from 25 percent in 1970 to 40 percent of the population around 2000.
For centuries, humans have corrected their blurry vision with glasses. In the 20th century, contact lenses became inexpensive, easy to produce, and safe, when used with appropriate cleaning habits. Disposable soft contact lenses allowed more people to wear these devices, since they are more gas permeable.
Long-term myopia is associated with a higher risk of retinal damage and vision loss, so finding solutions to curing myopia are important if rates continue to rise. Laser in-situ keratomileusis (LASIK) has been one of the most popular solutions, but not everyone is a good candidate for that surgery. ICLs, especially those from Visian, present an alternative to removing corneal tissue from your eye.
Who Benefits Most From Visian ICLs?
Visian ICLs can be a good option for many people who have myopia or astigmatism. These small devices are a type of toric lens, which is an artificial lens implanted in the eye to improve vision.
Until recently, most people who received toric lenses had undergone cataract surgery, so the natural, clouded lens in their eye was removed and then replaced with a synthetic toric lens. However, a modified toric lens can be implanted in the eye to work in concert with your natural lens, improving how light is refracted onto your retina and allowing you to see more clearly.
The Visian ICL specifically is implanted behind the iris, but in front of the natural lens. Adding an additional lens helps focus light without removing any tissue from your cornea, as in LASIK surgery. These lenses work best in people who:
- Have a stable refractive error, or no change of more than 0.5 diopters in the past year.
- Have myopia ranging from -3.0 to -15.0 diopters, with 2.5 diopters or less of astigmatism.
- Have myopia up to -18.0 diopters with astigmatism up to -6.0 diopters, for those using the newer, high myopia lenses.
- Are between 21 and 45 years old.
- Are not good candidates for LASIK due to personal preference or cornea thickness.
While LASIK offers treatment for a wide range of refractive errors, ICLs are intended only for people who have myopia. The lenses treat a specific range of myopia. Visian recently developed a new type of ICL for people with high myopia, and the devices have been approved by the FDA to treat astigmatism within a certain range too. However, ICLs are not approved to treat farsightedness, either hyperopia or age-related presbyopia.
As of 2018, about 9.5 million people in the U.S. have had LASIK. Though rare, the surgery has the potential to lead to certain side effects. While side effects tend to go away within six months, they can be annoying during that time. If you are not a good candidate for LASIK, you are at higher risk for suffering these side effects if you do get the procedure anyway.
Visian ICL offers an alternative for people with myopia or astigmatism. You may be a poor candidate for LASIK but a good ICL candidate if:
- You have high myopia or naturally thin corneas.
- You have had a previous refractive surgery.
- You have chronic dry eye, which can get worse from LASIK surgery.
- You want a replaceable option if your prescription changes a lot, or a new, improved form of Visian ICL is developed.
While fewer people have undergone Visian ICL surgery since LASIK is much more popular, the devices have a high success rate for improving vision.
Clinical Studies Show Visian ICLs Work Well
Clinical studies report that ICLs offer a good option to improve myopia or astigmatism, just like LASIK. One of the first studies of these lenses involving 210 participants, 124 of whom received Visian ICLs, found that 97.4 percent achieved improved visual acuity to within 1.0 diopter of their targeted refraction, or just shy of 20/20 vision. Almost 98 percent of the participants experienced 10 degrees or less of lens rotation within a year, so their vision did not change significantly.
Lens rotation was the most common side effect, which rarely occurred to any significant, sight-changing extent. Participants who did develop this problem underwent a second surgery to reposition, remove, or replace the lens. The clinical trial found that there was no significant loss of vision sharpness after the lens was replaced or repositioned.
A new study following 83 participants for five years, who received newer ICLs to treat higher myopia found that 95 percent of the eyes had 20/25 vision or better after ICL surgery. After five years, many of these participants had worsened visual acuity, but this was due to their natural myopia progression.
Data suggests that Visian ICLs are a great option for people who have myopia, astigmatism, or both, to improve their vision without losing any tissue from their cornea. The surgery itself shares many similarities with other cosmetic vision improvement surgeries, including LASIK.
The Visian ICL Surgical Procedure
Like any vision surgery, the Visian ICL surgery requires a complete eye exam and consultation with an optometrist or ophthalmologist. This ensures your eyes are healthy, you have no underlying conditions that would complicate the procedure, and your refractive error is within the ICL specifications.
You can also discuss any medications you take that are not involved directly in your vision. Underlying health conditions and some medications can impact your overall healing time.
Your eye surgeon will ask you to stop wearing contact lenses for two to four weeks prior to the exam. Even soft contact lenses have an impact on the shape of your cornea and how much oxygen your eyes receive. Giving your eyes time to reshape ensures your eye doctor gets a stable measurement of their shape.
Arrange transportation to and from the procedure. While the Visian ICL surgery is an outpatient procedure, meaning you will go home the same day as the operation, you will not be able to drive yourself. Your doctor will tell you when your vision is good enough to drive again.
Here’s an overall timeline of what to expect:
- Two to three weeks before surgery: Because Visian ICLs add material to your eye, you may experience higher eye pressure. To greatly reduce this risk, a few weeks before the ICL surgery, your eye surgeon will make two small holes with a guided laser on the extreme outside of your iris, or the colored portion of your eye. This ensures fluid in your eye flows properly from the back to the front of your eye.
- Up to the day of surgery: After the iridectomy procedure, you will use prescribed eye drops to keep your eyes healthy until the day before your operation. Then, your eye surgeon will ask you to stop using them.
- Day of surgery: You will receive numbing eye drops. Then, you’ll lie down so your surgeon can place devices on your eye to keep your eyelids open. A small incision will be made in your cornea, which is the clear material at the front of your eye. Finally, your eye surgeon will implant the Visian ICL.
The entire operation takes between 20 and 30 minutes, which is slightly longer than LASIK. You will receive medicated eye drops, and your surgeon may put a patch over your eye to protect it until the day after the procedure. You may need to wear a patch or shield for several days or weeks after the operation at night or while you shower, to ensure you do not scratch your eye or get anything inside it.
Your eye doctor will examine your eyes the day after the procedure. This helps to prevent any infection or damage to the eye.
Costs, Risks & Recovery From Visian ICL Surgery
Visian ICLs are a great option for many people, but they do cost more than LASIK. Reported prices can range from $1,500 to $5,000 per eye, depending on where you live, your eye surgeon’s experience, and other factors.
While many types of phakic lenses are covered, at least in part, by your vision or general health insurance, this is likely only when you need cataract surgery. ICLs are considered cosmetic, and they are not going to be covered by your vision insurance, so the cost is out of pocket.
As with any surgery, there are potential side effects and risks associated with ICL surgery. Clinical studies found that lens rotation was the most significant side effect to impact vision, but it was very rare. There is also a small, but increased, risk of:
- Infection (endophthalmitis).
- Undercorrection or overcorrection that requires another operation to correct the issue.
- Inflammation of the eye.
- Bleeding into the eye.
- Halos, glares, or double vision.
- Macular edema.
- Damage to the cornea.
- Developing cataracts.
- Increased eye pressure, leading to glaucoma.
- Iris prolapse.
- Needing a second eye surgery to remove the lens.
If you develop high ocular pressure, you may require a surgical procedure to reduce that pressure. Iris prolapse may necessitate surgery too.
In the rare case that your vision is not corrected to 20/40 or better, you may need glasses or contact lenses. It is possible to undergo a refractive laser surgery like LASIK to improve your vision further. Talk to your eye surgeon about this option.
Visian ICLs & the Future of Refractive Correction
It is very rare for people who receive Visian ICLs to need another procedure to improve their vision. This is partially because Visian’s device is considered, to some extent, replaceable. While these are not removable in the same way that soft or hard contact lenses are removable, the Visian ICL can be safely taken out and replaced with a new lens after a few years.
While the ICL procedure takes longer and has a slightly longer healing time than LASIK, you have the ability to keep improving your vision throughout life by periodically replacing these lenses. Depending on the situation, you may not be able to get subsequent LASIK procedures, particularly if your cornea is too thin after one operation.
Overall, LASIK is a much more popular procedure than ICL surgery. If you don’t think LASIK is the right procedure for you, talk to your eye doctor about ICL surgery and other options. They can help you weigh the pros and cons to make the best decision.
About. Visian ICL.
Nearly 10 Million Adults Found to Be Severely Nearsighted in the United States. (June 2016). American Academy of Ophthalmology (AAO).
LASIK. (July 2018). United States Food and Drug Administration (FDA).
Visian Toric ICL (Implantable Collamer Lens). (October 2018). United States Food and Drug Administration (FDA).
Summary of Safety and Effectiveness Data (SSED): Phakic Toric Intraocular Lens (IOL), Visian ICL. (September 2018). United States Food and Drug Administration (FDA).
Comparison of Implantable Collamer Lens Visian ICL V4 and ICL V4c for High Myopia. (June 2017). Medicine (Baltimore).
Refractive Errors. (July 2019). National Eye Institute (NEI).
Blurred Vision, Burning Eyes: This Is a LASIK Success? (June 2018). The New York Times.
When Is LASIK Not for Me? (July 2018). United States Food and Drug Administration (FDA).
New Implantable Collamer Lens Shows Good Safety Profile. (April 2019). American Academy of Ophthalmology (AAO).
Facts You Need to Know About STAAR Surgical’s Visian Toric ICL SURGERY. (2017). United States Food and Drug Administration (FDA).