To be a suitable candidate for ICL, you should be:
- At least 18 years old
- Specs number should be stable for about a year – minor changes do not disqualify you from becoming a candidate
- Ladies should not be pregnant or be breastfeeding
- Should not have any eye disease
- Controlling diabetes is not a contraindication.
Absolute Indications for ICL
- Eye power more than -8 dioptres up to -18 dioptres.
- Cornea thinner than 450 micrometers.
- Cylinder power of the eye more than 3.5 diopters.
- Unhealthy cornea including Keratoconus.
- Dry eye situations.
- Any situation where LASIK is not a suitable option.
Relative Indications for ICL
- All indications for LASIK/SMILE are also indications of ICL as it is considered to provide high definition vision and is not tampering with the cornea as in the case of LASIK/SMILE procedures.
Over 10,00,000+ ICL’s have been implanted worldwide over the last 20 years. ICL surgery is the best option in specs power of -8 or more. In lower powers, they are preferred when the cornea is thin, if you have dry eyes and LASIK is not advisable.
ICL is of two types, ICL Spherical and ICL Toric. Spherical ICL lens corrects only spherical power of glasses while Toric ICL lens corrects cylinder along with spherical power of glasses. Below is a comparison of both:
Where can Toric ICLs be used?
The Toric ICL over time has proven to be an extremely safe and effective option for better vision without glasses even for patients following surgery for:
- Corneal Transplants (including Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty, in cases with adequate anterior chamber depth),
- Who aren’t excellent candidates for LASIK,
- Patients with thin corneas
- Astigmatism, due to other corneal ectasias.
- Sometimes, patients’ eyes are not fully corrected following refractive surgeries like LASIK, SMILE, etc, and after intraocular lens transplant following cataract removal. Toric ICLs can also be used for these patients with residual refractive error to allow them a complete spectacle free life.
The Spherical ICL is usually prescribed for people (21 – 60) who have a Moderate to High power of glasses, and where the usual LASIK procedures cannot correct the same due to either very high refractive error or thin corneas. The spherical ICL may be used for the correction of moderate to high myopia ranging from – 3.0 D to –20.0 D. However, they are most commonly used in powers beyond -8 DS in eyes with normal corneas, or in eyes with lower power very thin corneas.
The spherical ICL offers perfect vision correction to patients who do not require cylindrical correction for their astigmatism, that is, their refractive error is purely spherical.
Benefits of Spherical ICL
- The vision results of ICL are sharper with a superior quality of vision than after other refractive surgeries.
- The visual recovery is almost immediate
- The lens is invisible to both the patient and observers
- The ICL is free from the frequent problems associated with contact lenses like infections, allergies, and dry eyes
- Ideal surgical procedure for patients with preexisting ocular surface diseases where the conventional refractive surgeries like LASIK are known to aggravate the preexisting condition.
- Since the lens is made of a biocompatible, flexible Collamer, which contains an UltraViolet light protector, the ICL completely prevents harmful UVA and UVB rays from entering the eye.
The ICL is inserted into the eye using a small, almost painless incision, and the surgery usually takes about fifteen minutes. Spherical ICL can be used in patients with thin corneas, large pupils, as well as dry eye, and in refractive errors as high as -20D, all of which are not suitable candidates for LASIK.
Like other refractive surgeries, it is a permanent solution for refractive errors and spectacle free life. In addition to that, the most remarkable part of the procedure is that it is entirely reversible, unlike LASIK. It means that the surgeon can undo the procedure in the future in case newer, better technology is available, or in case the patient wants to revert to his or her original refractive status for any reason.
Spherical ICLs have revolutionized the outcomes of refractive surgeries in the subset of patients who need it the most, but till now, have had no options but to continue with glasses.