Candidates for Implantable Collamer Lense?

Can a cornea be too "weak" to be a candidate for laser eye surgery and it be appropriate to consider "Implantable collamer lenses" as an alternative? Is this something all doctors recommend in these situations? Are Implantable collamer lenses are well understood and safe technology, or is there still lots of possible error and risk?

Doctor Answers 5

ICL or Implantable Collamer Lens

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The ICL is a premium vision option and is often used for individuals whose corneas are too thin or prescriptions too high. A lens, similar to a contact lens, is inserted into the eye just behind the iris in front of the natural lens.  It avoids the removal of tissue from the cornea, or front surface of the eye and may be safer for you. Not all eye doctors that perform LASIK are certified to perform this procedure.

San Diego Ophthalmologist

Implanted Collamer Lenses for the Correction of High Myopia

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The ICL can be a wonderful method to correct high amounts of nearsightedness.  It is a lens that is placed inside of the eye in front of your own natural lens.  It is sometimes combined with LASIK for fine-tuning particularly in those with astigmatism.  Recently, I have heard some surgeons recommend the ICL instead of LASIK by saying that the prescription is too high because they did not perform Laser Vision Correction.  LASIK and PRK are hugely safer when a logical option.  I would suggest that anyone who is told about ICL seek a second opinion from  a Laser Cener.  If you have a prescription above a -8.00 it is probably always reasonable.

Mark Golden, MD
Chicago Ophthalmologist

Visian ICL and other phakic lens implants have been FDA approved for years

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Visian ICL and other phakic lens implants have been FDA approved for years now but few surgeons perform these procedures.  Web sites like STARR (for Visian ICL) can help direct those interested consumers to appropriate surgeons.  These procedures often make sense for thin or “funny looking” corneas.

Christopher Coad, MD
New York Ophthalmologist

Implantable Lenses (ICL) versus LASIK

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The implantable collamer lens, or ICL, is generally an excellent option to consider for patients who do not qualify for LASIK or PRK due to the health of their cornea.  Also referred to as a phakic intraocular lens, it avoids the risks caused by creating a flap (LASIK), removing corneal epithelium (PRK), or  removing tissue from the central cornea (both).  As such, although the procedure does involve entering the eye to implant the lens, many surgeons with extensive experience in ICL implantation actually consider the procedure less invasive than laser-based corneal refractive procedures.   The collamer substance, a very inert biomaterial, is in fact very well understood, and has been used for a number of intraocular lenses besides the ICL for many years without any reports of rejection or inflammation caused by the material.  While the first ICLs were implanted in human eyes in Europe and South America in 1993, the FDA study of the STAAR Visian ICL began in the US in 1997, and it was approved in December of 2005.  Consequently, we now have 17 years of international experience, with 13 years of followup in the US; ICL patients have fared exceptionally well over the years.  Not all patients are candidates for the ICL, however, so you should discuss with your surgeon why he or she feels this is the best option for you.  For general information from the manufacturer of the lens, you can also refer to their visianinfo website.

Robert Rivera, MD
Phoenix Ophthalmologist

Implantable Lenses versus LASIK

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If you have been told your cornea is too thin to have LASIK, then it is likely you are still a good candidate for an implanted lens. This is an excellent procedure, however it is a bit more invasive than LASIK. Remember, LASIK(and PRK) are performed on the surface of the eye. Implanted lenses are placed inside the eye after a very small(2.5mm) incision is made. While the  risk is very slight, there is a somewhat higher incidence of infection and other complications because the eye is surgically entered. If the surgeon is good, as well as honest, you should be able to trust him/her to give you the proper advice as to which procedure is best for you.

Anthony J. Kameen, MD
Baltimore Ophthalmologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.