Phakic lenses represent a brilliant method to correct refractive errors
(myopia, hyperopia, astigmatism)
ICL (Implantable Collamer Lens) are intraocular lenses capable of correcting myopia up to 18 diopters, whether or not associated with astigmatism. The material of these implants is perfectly biocompatible. This lens has shown great short and long term results with minimal side effects or complications. ICLs are generally reserved for patients with a contraindication to a laser procedure or for patients with high ametropia (> 10 diopters) for whom the laser might have suboptimal results.
The surgery is usually performed under local anesthesia and lasts 15 minutes. The ICL is inserted through a corneal micro-incision (3 mm). It unfolds inside the eye and positions itself behind the iris.
One to three hours after surgery, your surgeon will check your eye pressure and the position of the lens. There is no pain, maybe a slight burning sensation. Significant improvement in visual acuity is noted after 24 hours and visual quality continues to improve for the first 2 to 4 weeks.
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A 2009 metanalysis published in the reference journal “ophthalmology” concludes that the placement of phakic ICL implants is effective and safe and allowed stable refractive results for the treatment of moderate and severe myopia. Other studies report good refractive stability over nearly 8 years of follow-up. In strong ametropia (myopia beyond 8 diopters) the quality of vision obtained after placing an intraocular implant is superior to that obtained by corneal laser surgery.
Video of a procedure showing the preparation of the implant as well as its insertion in the eye and its positioning behind the iris and in front of the lens.
Animation visualizing the implant and its insertion in the eye (property of Visian ICL).
Real example - Clinical case
Above: Anonymized medical file of a very myopic patient:
Right eye: -23.75 diopters of myopia and -3.75 diopters of astigmatism
Left eye: -23.25 diopters of myopia and -4.24 of astigmatism.
Below: Refraction 7 years after ICL placement and surface laser surgery (the ICL implant can correct up to 18 diopters of myopia; in this specific case corneal surface laser surgery was associated to correct all ametropia on the right eye and to leave a small residual myopia on the left eye in order to prevent presbyopia. Note the improvement in the best corrected visual acuity which goes from 5/10 preoperatively to 8 / 10 postoperatively.
OCT of the anterior segment (Optical Coherence Tomography, Anterion, Heidelberg) showing the pre-crystalline implant (ICL) in place and distant from the lens (vaulting) by nearly 600 microns.