Implantable Collamer Lens (ICL) surgery is a popular vision correction option that involves placing a small, biocompatible lens inside the eye, working with the natural lens to sharpen focus. As an internal procedure, it is understandable to question whether this surgery causes pain. The procedure itself is not painful due to modern numbing techniques, but patients should expect a period of discomfort as the eye begins to heal afterward.
The Role of Topical Anesthesia
Pain during the ICL procedure is prevented by specialized numbing eye drops, which provide a form of local anesthesia known as topical anesthesia. These drops are applied directly to the surface of the eye, effectively blocking pain signals from the cornea and the conjunctiva, the clear membrane covering the white of the eye. This method eliminates the need for general anesthesia or an injection around the eye, allowing the patient to remain awake and comfortable throughout the short procedure.
The eye drops work quickly, rendering the eye’s surface insensitive to the small incisions and manipulation required to insert the lens. A mild oral or intravenous sedative is often offered before the procedure to manage anxiety. This medication induces a state of deep relaxation, helping the patient remain calm and still while the surgeon works. The combination of topical anesthesia and optional mild sedation ensures a pain-free experience during the actual operation.
Sensations Experienced During the Procedure
While the eye is completely numb to pain, the patient will still perceive several non-painful sensations during the 15- to 30-minute procedure. One of the most common perceptions is a feeling of pressure as the surgeon gently manipulates the eye to create the micro-incisions and insert the lens. This pressure is often described as a dull pushing sensation, distinctly different from sharp pain.
Patients also notice bright, often colored, lights from the operating microscope that shine directly into the eye. There may also be a sensation of cold liquid washing over the eye, which is the sterile solution used to keep the eye lubricated and clean during the surgery. These sensations confirm the patient is awake and aware, but they are sensations of touch and light, not pain.
Acute Post-Operative Discomfort and Management
The most significant discomfort occurs in the hours immediately following the surgery, once the numbing eye drops have worn off. This acute post-operative period, typically lasting 24 to 48 hours, is characterized by a foreign body sensation in the eye. Patients often describe this as a scratchy, gritty feeling, similar to having sand stuck under the eyelid.
Other common symptoms include mild burning, excessive tearing, and noticeable light sensitivity, all of which are a normal reaction to the corneal incision and internal manipulation. To manage this discomfort, a regimen of medicated eye drops is prescribed, usually including an antibiotic to prevent infection and a steroid to reduce inflammation. Non-prescription pain relievers, such as acetaminophen or ibuprofen, are generally sufficient to control any residual ache. Wearing a protective eye shield, especially while sleeping, is also standard practice.
Expectations During the Full Recovery Period
Beyond the first two days, the acute discomfort subsides dramatically, transitioning into milder, lingering symptoms as the eye completes its healing process over the next several weeks. It is common to experience temporary fluctuations in vision, where sight may seem blurry or hazy, particularly in the mornings. This fluctuation is a normal part of the eye’s adjustment to the new lens and the resolution of minor swelling.
Mild dry eye, which may necessitate the frequent use of preservative-free lubricating drops, is also a common complaint during this time. Patients may notice visual disturbances, such as halos or glare around lights, which are typically most noticeable at night and gradually diminish as the eye heals. While the full healing period can take up to a month, most patients return to non-strenuous daily activities within one to two days. Sharp, throbbing pain during this phase is considered abnormal and should be reported to the surgeon immediately.