Implantable Collamer Lenses (ICL)

Implantable Contact Lens / Phakic implants

The Implantable Collamer Lens (also known as Implantable Contact Lens) is a refractive lens implanted inside the eye to correct near-sightedness, far-sightedness or astigmatism. The ICL is implanted through a key-hole incision in the eye behind the iris (the coloured part of the eye), and in front of the natural crystalline lens. Mr Gore is a Visian ICL certified surgeon.

The ICL can correct a wide range of refractive errors between +10 (far-sightedness) and -18 (near-sightedness). Astigmatism of up to 6 dioptres can also be corrected. Your spectacle prescription should ideally have been stable for at least a year prior to surgery.

The ICL represents an alternative to other laser refractive surgeries LASIK or LASEK/TransPRK.
Additional information about ICL surgery is available from the Royal College of Ophthalmologists.
You can also get answers to some frequently asked questions about the procedure below.

What are the different types of laser eye surgery?
In LASIK eye surgery, a femtosecond laser – which emits ultra-fast pulses of light allowing for extreme precision– is used to ‘cut’ a thin flap of corneal tissue, underneath which an excimer laser – utilising ultraviolet light – is applied. The flap is then laid flat at the end of the procedure.

Recovery after LASIK eye surgery is rapid with minimal discomfort, and most patients achieve driving standard vision the following day.

TransPRK, PRK and LASEK eye surgeries are all examples of laser treatments applied directly to the surface of the cornea (without a flap). LASEK and PRK both involve manually brushing away the corneal skin layer (epithelium). A more advanced technique, transepithelial PRK (TransPRK), reshapes the cornea through the epithelium. TransPRK is the only ‘no-touch’ technique for laser refractive surgery - applying the laser light directly to the surface of the eye means no brushing, no cutting and no flap.
How long does the surgery take?
Both LASIK and TransPRK are very quick procedures. Two different lasers are used during LASIK - one to create the flap (the femtosecond laser) and another to reshape the cornea underneath the flap (the excimer laser). Treating each eye takes about 10 minutes, with the laser part lasting only a few seconds at a time. TransPRK surgery only requires one laser, with the procedure lasting less than one minute per eye.
Does the procedure hurt?
No. Anaesthetic drops are used to numb the eyes so that no pain is felt during the procedure. During LASIK, you may feel some pressure while the flap is created. If you are really nervous at the thought of laser eye surgery, a sedative in the form of a tablet can be given to help you stay relaxed.
Is vision improvement from laser eye surgery permanent?
Natural changes in your prescription can occur at any age, irrespective of previous surgery. Laser surgery will not prevent normal age-related development of cataracts. Further treatment may, therefore, be required as you get older. If your vision is not sufficiently corrected after LASIK or TransPRK, enhancement surgery is provided free of charge within 2 years of your initial treatment.
How long does it take to recover after laser eye surgery?
Discomfort after LASIK treatment is minimal, and you should be able to return to work within a couple of days.

Recovery after TransPRK is slower and more uncomfortable. In the first 24-48 hours following TransPRK surgery the eyes can be painful and light sensitive while the eye's surface skin layer (the epithelium) heals. Light sensitivity is a near-universal symptom for a short time following treatment. Regular use of the lubricating drops provided will soothe the eyes. You will also be given some anaesthetic ‘numbing’ drops to help you get through the first day. You should expect to take a week off work following TransPRK.
How good will my vision be following laser eye surgery?
Compared to your pre-treatment unaided vision, your vision immediately after the surgery will likely already be better, although it will be hazy. Vision recovery after LASIK is quick, with most patients achieving driving standard vision the very next day. Following TransPRK, the vision can be very blurred for the first few days, with two-thirds of patients reaching driving standard vision by the end of the first week. Your vision will continue to improve during the following weeks. The final vision results for both LASIK and TransPRK are the same.

Dry eye, night glare and haloes (which are rings around light sources) can occur following laser vision correction. Symptoms typically improve over the first few weeks, but may persist for several months. Long-term dry eye is very rare.
I have dry eyes - can I have laser eye surgery?
Discomfort wearing contact lenses due to dry eyes is one of the most common reasons for seeking laser eye surgery. In most cases, laser surgery can still be performed - treatment to improve the ocular surface may be required prior to surgery to optimise the results.
Who should not have laser eye surgery?
There are a number of reasons why laser surgery may not be suitable: For example, if your corneas are too thin, or your prescription is too high, lens implants may be a safer alternative. LASIK is not suitable for younger patients, or those at high-risk of flap dislocation (e.g. contact sports players); in this situation, a surface laser treatment (LASEK/TransPRK) may be a safer alternative. Mr Gore will discuss options with you during your consultation.
What are the risks of laser eye surgery?
Overall, laser eye surgery is very safe. The risk of a serious complication (e.g. infection, scarring, ectasia) requiring a corneal transplant to restore vision is approximately 1 in 5,000. This compares with the risk of a serious corneal infection due to the wearing of contact lenses of approximately 1 in 3,000 per year.

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