Implantable Collamer Lens (ICL) surgery is a vision correction procedure designed to offer a permanent solution for refractive errors like myopia, hyperopia, and astigmatism. This minimally invasive technique provides an alternative to wearing external corrective devices. The procedure has gained popularity, particularly among individuals who may not be suitable candidates for traditional laser vision correction methods. It works by implanting a corrective lens inside the eye, where it works in conjunction with the eye’s natural focusing components.
The Implantable Collamer Lens Defined
The ICL is a phakic intraocular lens crafted from Collamer, a unique, flexible material that is a proprietary blend of collagen and a polymer. This material is highly biocompatible, allowing the eye to accept the lens without triggering a foreign body reaction, so it can remain in place indefinitely. The lens is positioned in the posterior chamber of the eye, located directly behind the iris and in front of the eye’s natural crystalline lens.
The ICL acts as an additional, permanent corrective element that precisely focuses incoming light onto the retina. Because the natural lens is not removed and the cornea is not permanently reshaped, the procedure is described as additive. This means that, unlike laser procedures, ICL surgery is reversible; the lens can be removed or replaced if a patient’s vision changes significantly or if future technologies become available.
The ICL Surgical Process
The ICL implantation procedure is performed on an outpatient basis and typically takes about 20 to 30 minutes per eye. Before the surgery begins, the eye is prepared with dilating drops, and topical anesthesia is administered to numb the surface, ensuring a comfortable experience.
The surgeon creates a micro-incision, usually less than three millimeters, at the edge of the cornea. The flexible Collamer lens is then folded and gently inserted through this tiny opening into the eye’s anterior chamber. Once inside, the lens gradually unfolds on its own, utilizing its engineered flexibility.
The final step involves the surgeon carefully positioning the lens to rest securely in the posterior chamber, behind the iris. The small corneal incision is designed to be self-sealing and typically requires no stitches. Patients often experience a rapid improvement in vision immediately following the procedure, and full recovery is relatively quick, with many resuming normal activities within a few days.
Essential Criteria for Candidacy
ICL surgery is often the preferred option for individuals who do not meet the requirements for laser vision correction like LASIK. Candidates are generally between the ages of 21 and 45, and they must have a stable vision prescription that has not changed significantly for at least one year. The procedure is particularly advantageous for correcting high levels of myopia, sometimes up to -20.00 diopters, which is often beyond the safe treatment range of laser ablation.
A major group of suitable candidates includes those with corneas that are too thin to withstand the tissue removal required by LASIK or PRK. Since ICL is an additive procedure, it maintains the cornea’s natural strength and integrity. Patients must also have overall good eye health, meaning they should not have active eye diseases such as uncontrolled glaucoma, cataracts, or diabetic retinopathy.
The eye’s internal anatomy is also assessed, as there must be sufficient space, particularly the anterior chamber depth, to safely accommodate the implanted lens. Women who are pregnant or breastfeeding are advised to postpone the procedure, as hormonal changes can cause temporary fluctuations in vision. A thorough pre-operative examination is necessary to confirm that all anatomical and health requirements are met.
ICL Compared to LASIK and PRK
The fundamental difference between ICL surgery and laser procedures like LASIK and PRK lies in the mechanism of vision correction. ICL is an additive procedure, where a lens is implanted to work with the existing eye structure. Conversely, LASIK and PRK are ablative procedures that permanently reshape the cornea by removing microscopic amounts of tissue using an excimer laser.
ICL maintains the integrity of the cornea, which is a significant advantage for patients with thin corneas who would otherwise be ineligible for laser treatment. The preservation of corneal tissue also means ICL does not affect the nerves responsible for tear production as much as laser surgery, leading to a lower incidence of post-operative dry eye syndrome.
ICL offers the unique benefit of reversibility, as the lens can be surgically removed if necessary, while the tissue removed in LASIK or PRK cannot be replaced. The implanted lens provides a high-definition quality of vision and is often considered superior for correcting severe prescriptions. The Collamer material also includes built-in ultraviolet (UV) protection, a safety feature not offered by the laser-based methods.