Types of Implantable Collamer Lens Surgery

Implantable Collamer Lens surgery has emerged as a popular and effective alternative to LASIK and other refractive eye surgeries. With its ability to correct moderate to severe myopia, hyperopia, and astigmatism, ICL surgery offers excellent visual outcomes for individuals who may not be ideal candidates for laser-based procedures. Unlike LASIK, which reshapes the cornea, ICL involves the placement of a biocompatible lens inside the eye, preserving the corneal structure while delivering clear, sharp vision.

Vision correction has come a long way from traditional glasses and contact lenses. With the rapid advancement of ophthalmic technology, surgical procedures like lasik, PRK, and SMILE have helped millions achieve freedom from corrective eyewear. However, not everyone is a suitable candidate for laser-based eye surgeries especially those with thin corneas, high refractive errors, or chronic dry eyes. This is where Implantable Collamer Lens (ICL) surgery offers a revolutionary alternative.

What is implantable collamer lens surgery?

Implantable Collamer Lens surgery involves placing a soft, flexible lens between the natural lens and the iris (posterior chamber) to correct refractive errors. Made of Collamer a biocompatible material containing collagen ICL lenses are well-tolerated by the eye and provide UV protection, making them ideal for long-term implantation.

ICL surgery is often referred to as phakic intraocular lens (PIOL) surgery because it leaves the natural lens of the eye intact, unlike cataract surgery. It is suitable for patients aged 21 to 45 who have stable vision, high refractive errors, thin corneas, or dry eyes—conditions that may exclude them from LASIK eligibility.

Types of implantable collamer lens surgery

There are several types of ICL surgeries, each tailored to specific vision problems and patient profiles. The main types include :-

Visian ICL for Myopia (Nearsightedness)

Overview :- This is the most common form of implantable collamer lens surgery, designed specifically to correct myopia ranging from -3.00 D to -20.00 D.

Procedure :-

1. A small incision is made in the cornea.

2. The folded ICL is inserted and positioned between the iris and the natural lens.

3. The lens unfolds naturally and rests in place, correcting the refractive error.

Benefits :-

1. Quick recovery with minimal discomfort.

2. Provides HD-quality vision.

3. Preserves corneal tissue and natural lens.

4. Reversible and removable.

Ideal Candidates :-

1. Patients aged 21–45 with stable myopia.

2. Those with thin corneas or contraindications to LASIK.

Visian Toric ICL for Myopic Astigmatism

Overview :- The Toric ICL is designed to correct both myopia and astigmatism in a single procedure. It is ideal for patients with cylindrical power along with nearsightedness.

Procedure :-

1. Similar to standard ICL, with additional lens alignment to match the axis of astigmatism.

2. Surgeons use detailed pre-op mapping for precise placement.

Benefits :-

1. Eliminates the need for toric glasses or contact lenses.

2. Single surgery for dual refractive errors.

3. Maintains natural corneal shape and lens.

Ideal Candidates :-

1. Patients with myopia and astigmatism (cylinder power up to 4.00 D).

2. Patients unsuitable for LASIK due to thin corneas or dry eyes.

Visian ICL for Hyperopia (Farsightedness)

Overview :- Though less common, hyperopic ICLs are available to treat farsightedness, generally in the +3.00 D to +10.00 D range.

Procedure :-

1. The surgical steps are similar to myopic ICL insertion.

2. The lens used is designed to shift focus for distant objects.

Benefits :-

1. Offers a solution for high hyperopia where LASIK may not be suitable.

2. Provides better contrast sensitivity and depth perception.

Ideal Candidates :-

1. Adults with high levels of hyperopia.

2. Those who cannot undergo laser vision correction.

Visian Toric ICL for Hyperopic Astigmatism

Overview :-

This version of the ICL is designed for patients with both hyperopia and astigmatism, a combination that can be more challenging to correct.

Procedure :-

1. Requires advanced biometric measurements and lens customization.

2. Implantation is done with precise axis alignment to address both conditions.

Benefits :-

1. Dual correction in one surgery.

2. High degree of visual clarity and patient satisfaction.

Ideal Candidates :-

1. People with high hyperopia and significant astigmatism.

2. Patients preferring a non-laser option.

Advanced EVO Visian ICL with Centraflow Technology

Overview :-

The latest evolution in ICL surgery, EVO Visian ICL, features a central port called Centraflow. This eliminates the need for a preoperative peripheral iridotomy, simplifying the procedure.

Procedure :-

1. Similar to traditional ICL surgery, but the lens has a 0.36 mm central hole that allows natural fluid flow.

2. No pre-op laser hole in the iris is needed.

Benefits :-

1. Faster procedure with fewer steps.

2. Enhanced safety with natural aqueous humor flow.

3. Immediate vision improvement.

4. Lower risk of elevated intraocular pressure.

Ideal Candidates :-

1. Patients seeking a simplified, advanced ICL experience.

2. Those interested in minimal disruption and quicker recovery.

How to Choose the Right Type of ICL Surgery?

Choosing the right type of ICL surgery depends on several factors :-

1. Refractive error type and severity (myopia, hyperopia, astigmatism)

2. Corneal thickness

3. Pupil size

4. Age and overall eye health

5. Lifestyle and visual demands

A thorough pre-operative evaluation, including eye measurements, corneal mapping, and pupil assessment, is necessary to determine the ideal ICL model and power. Consulting a certified ophthalmologist who specializes in refractive surgery is crucial for making an informed decision.

Advantages of Implantable Collamer Lens Surgery

Regardless of the type of ICL surgery, all variations offer several core advantages :-

1. High-definition vision quality with sharp contrast.

2. Preservation of corneal structure, especially beneficial for those with thin corneas.

3. Reversibility :- ICL lenses can be removed or replaced if necessary.

4. UV protection from built in UV filters in the lens.

5. Quick recovery :- most patients experience improved vision within 24 hours.

Risks and Considerations

While ICL surgery is safe and effective, like all surgical procedures, it carries potential risks :-

1. Increased intraocular pressure

2. Cataract formation (rare in younger patients)

3. Halos or glare, especially in low-light settings

4. Risk of infection or inflammation

These risks can be minimized with proper surgical technique and post-operative care. Patients are typically prescribed eye drops and instructed to avoid strenuous activities for a few days post-surgery.

Conclusion

Implantable Collamer Lens surgery offers a transformative vision correction solution for individuals who aren’t suitable candidates for LASIK or PRK. With multiple types of ICL surgeries—ranging from standard myopia correction to advanced EVO ICL with astigmatism correction—patients now have personalized options for their visual needs.