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Icl Surgery: Purpose, Procedure, and Benefits and Side Effects

Last Updated: Jul 01, 2023

What is Implantable Collamer Lens (ICL) surgery?

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Implantable Collamer Lens (ICL) surgery, sometimes referred to as EVO Implantable Collamer or Intraocular contact lens surgery, is an alternative to Lasik. An eye surgeon who has undergone particular training inserts a permanent artificial lens without removing natural lens to treat ocular conditions, such as;

  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Astigmatism
  • To implant an ICL surgical intervention is required where a surgeon inserts the lens between the eye's natural lens and colored iris. The lens works with the eye's natural lens to improve vision by refracting (bend) light onto the retina.
  • A collagen substance called collamer and plastic are used to make the ICL. This kind of intraocular lens is phakic which means the lens is inserted into the eye without removing the natural lens.
  • Although ICL surgery may not necessarily treat vision issues, it can, however, lessen or even replace the need for glasses or contact lenses.

Types of Implantable Collamer Lens (ICL) surgery

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Soft Lens ICL

A soft lens justifies its name as it is made of a flexible polymeric material. Because of the design's resemblance to corneal collagen, there is a reduced chance of any unfavorable reaction.

During the soft lens ICL,the surgeon makes a small incision in your cornea and inserts the soft lens ICL between your iris and lens. This procedure does not need any stitches.

Intraocular Lens

Patients who have extreme nearsightedness and don't meet the requirements for Lasik surgery are often recommended for this kind of ICL surgery. In order to improve eye focus, the surgeon inserts the lens between the cornea and the iris during this implant.

To ensure that the lens stays in position, surgeons seal the incision with microscopic stitches. The general function of this kind of lens declines as you get older. Later in life, patients could require reading glasses. A doctor must remove the intraocular lens from a patient who has cataracts in order to undertake the necessary remedial surgery.

Both surgical procedures preserve the normal lens of your eye. Your vision will be improved without the use of contacts or glasses.

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Benefits of Implantable Collamer Lens (ICL) surgery

The benefits of an ICL are numerous and go beyond better eyesight. Some of the benefits of ICL surgery are as follows;

  • It can treat extreme nearsightedness that other operations are unable to treat
  • UV protection
  • If your eyes are frequently dry, the lens is less likely to result in dry eyes
  • It can be removed if required
  • Great night vision is provided by the lens
  • Because tissue is left in place, recovery is frequently rapid
  • No maintenance is required
  • ICL may be an option for those who are not candidates for laser eye surgery.

Why is Implantable Collamer Lens (ICL) surgery done?

ICL implantation is frequently administered to young patients who are not candidates for laser vision correction. This is because the ICL can be a safer alternative for people who already have corneal or eye surface issues, and may correct a wider range of spectacle prescriptions than laser vision correction. The doctors often suggest ICL to treat astigmatism, a common vision issue that produces blurred vision due to the irregular shape of the cornea or occasionally because of the curvature of the lens inside the eye, as well as short-sightedness (myopia). Patients with vision ranging from -0.50 to -18.00 can undergo the ICL surgery to treat short-sightedness.

What are the risks of Implantable Collamer Lens (ICL) surgery?

Like any other surgery there are also some risks involved in Implantable Collamer Lens (ICL) surgery, such as;

  • Vision loss
  • Changes in vision
  • Results aren’t guaranteed
  • Additional surgery
  • pressure behind the eyes
  • Detached retina
  • Infection

Despite the risks, an ICL surgery can be a good choice for people with vision issues. The chances of countering the risks can also be ignored or reduced if the surgery is done by an expert eye surgeon at Pristyn care.

How do I prepare for Implantable Collamer Lens (ICL) surgery?

Speak with a reputable healthcare professional of Pristyn care before the procedure to receive detailed instructions on how to get ready for the surgery. Your medical professional might be able to provide you with information about the pre- and post-surgery preparation and treatment that may include;

  • About two weeks prior to surgery, your doctor will do a YAG laser iridotomy. In order to ensure normal aqueous humor flow, this treatment entails making tiny holes in the anterior chamber of your eyes. Iridotomy reduces postoperative pressure development
  • Your eye surgeon will conduct a thorough eye exam a week prior to the surgery to ensure that your eyes are healthy and appropriate for the procedure. Additionally, your pupil, cornea, and endothelial cell count will also be examined
  • Your ophthalmologist will advise against using contacts ( if you wear them) for a few days to a few weeks prior to the procedure so that your eyes function normally during the time of the procedure
  • Information of any medications you are taking, including over-the-counter medicines and dietary supplements, should be disclosed to your doctor. These drugs will likely need to be stopped in the days leading up to the surgery
  • If you take aspirin or other blood-thinning medications, you may need to discontinue taking them a few days before surgery
  • To lower the chance of infection, give up smoking at least 4 weeks ahead
  • Switch to healthy diet weeks before undergoing the surgery
  • If you've had any recent operations, have allergies, let your doctor know
  • Based on the timing of the surgery, your doctor will decide how long you should fast, or refrain from eating or drinking anything. To prevent any problems, strictly follow their instructions
  • Last but not least, arrange for dependable transportation to and from surgery. After having eye surgery, you won't be allowed to drive as you might have distorted vision.

How is Implantable Collamer Lens (ICL) surgery done?

Before the procedure

  • One week prior to the procedure, your ophthalmologist will create tiny little holes between the anterior chamber (front of your eye) and natural lens with the help of a laser. This will stop the fluid buildup and pressure in the eye following the treatment
  • Do not wear any makeup or fragrances on the day of ICL operation
  • Avoid using fake eyelashes for at least a week before the surgery
  • Prefer eating soft foods before surgery
  • It is necessary to have one friend or relative accompany you
  • An eye shield must be used to protect the eyes from potential infection and scratching
  • You can take medications for some underlying conditions, such as hypertension, diabetes, and cardiovascular disease
  • Anticoagulant medications, such as warfarin and other antiplatelet must be stopped at least 7 to 10 days before surgery, or as directed
  • Additionally, continue using antibiotics or anti-inflammatory eye drops prescribed by your doctor
  • It is important to notify the ophthalmologists as soon as possible if any unusual symptoms arise prior to the scheduled surgery, such as eye irritation
  • When you get to the doctor's office, the doctor will prepare your eyes while you sit on a reclining chair
  • Your pupils will first be enlarged by dilating eye drops that will be given to you
  • To reduce pain and discomfort during surgery, they will then apply a topical anesthetic. They might also give you a sedative to help you relax
  • After that, your surgeon will clean the eye and its surroundings. They will hold your eyes wide while preparing them for surgery using a tool known as a speculum

During the procedure

  • After cleaning your eye the surgeon will make a small cut in your eye and put a lubricant in order to protect your cornea
  • The incision will be used to insert the ICL which is a very thin lens, hence it might be folded then unfolded in the eye for better placement
  • Now the lubricant will be removed and suture will be done to close the incision
  • An eye drop or ointment will now be used before covering the eye with an eye patch

After the procedure

  • The whole procedure roughly takes 20 to 30 minutes. After which you’ll be taken to a recovery room where you’ll be put under close monitoring for a few hours.
  • To manage post operative pain after your anesthesia wears off, the doctor might prescribe some eye drops or oral medication
  • As ICL surgery is an outpatient operation you will be discharged on the same day, but you’ll need to have a ride as your vision might be distorted due to surgery
  • You are required to have a follow-up appointment the next day of your surgery. During the consultation a general eye check up will be done to see your progress
  • You will have follow-up appointments 1 month and 6 months after surgery over the course of the following year. A yearly checkup with your doctor will also be required.

How much does Implantable Collamer Lens (ICL) surgery cost?

The cost of ICL surgery heavily depends on where you get it. Generally it varies from about INR 80,000 to INR 1,25,000 per eye. If it's through insurance, your service provider will bear the majority of the cost and if your insurance plan requires co-pays, you will have to pay a small bit more. Also as hospitals have different prices, a huge corporate hospital will undoubtedly charge more due to the level and the quality of care provided in comparison to a smaller hospital that will still offer the same level of care but at a low cost. Moreover, it also depends on the surgeon and many other factors as no surgery has a generalized fixed price and can be custom quoted based on the patients' requests.

What to do after Implantable Collamer Lens (ICL) surgery?

Following ICL surgery, patients are advised to;

  • Take prescription oral medications and eye drops exactly as directed by the ophthalmologist Follow-ups must be kept up on a frequent basis
  • Following surgery, the eye shield shouldn't be taken off. The ophthalmologist will have it removed after an inspection the day following surgery
  • When the eyes are first opened, vision may be hazy or blurry which will eventually get better if you religiously follow eye drops regime.
  • Every time before using eye drops, wash your hands
  • Avoid getting tap water in your eyes for at least two weeks
  • Avoid using saunas, whirlpools, and pools
  • Apply a few clean, damp wipes to the face and eyes to keep them clean
  • Eyes must be gently cleansed
  • It is advised to lay flat when washing your hair to avoid getting water in your eyes
  • Eye shield should be worn when sleeping for at least a week following surgery, or as directed, to prevent unintended scratching
  • It is advised to use sunglasses to shield your eyes from the sun, wind, and pollution
  • Resume normal exercise regime only after a month following surgery
  • When exhibiting unusual symptoms, such as a burning sensation in the eyes or blurred vision, it is imperative to seek medical assistance right away, even before arriving at appointmentsAvoid straining your eyes by not spending much time reading, watching TV, playing computer games, or using your phone.

What to eat after Implantable Collamer Lens (ICL) surgery?

To hasten recovery after ICL eye surgery you should consume nutritional foods that are rich in Vitamins, particularly vitamin C, healthy fats, protein, carbohydrates such as;

  • Citrus fruits
  • Red bell peppers
  • Green leafy vegetables
  • Milk
  • Carrots
  • Tomatoes
  • BerriesAvocado
  • Sweet potatoes
  • Whole eggs
  • Seeds
  • NutsChicken (organic)
  • Salmon
  • Eggs
  • Dairy products
  • Nuts
  • SeedsQuinoa
  • Whole wheat
  • Bananas
  • Oats
  • Buckwheat

Is Implantable Collamer Lens (ICL) surgery safe?

Implantable Collamer Lens or ICL surgery has been found to be safe with an impressive success rate. However, there are some factors that need to be considered and discussed before opting for an ICL surgery to ignore any complication and get optimal results.

When considering the procedure, talk to your surgeon about following factor as the surgery may not be a good choice if you;

  • Are breastfeeding or pregnant
  • Are 45 years of age or older
  • Younger than 21, or have a chronic condition that alters hormone levels
  • Are using medications that could affect eyesight changes
  • Lack the necessary endothelial cell count required
  • Have a disease that prevents effective wound healing
  • You'll also need to take additional precautions prior to the procedure. For instance you will need to stop wearing contact lenses in the weeks before the treatment.
  • The appropriate safety precautions in your circumstance can be explained by the concerned doctor.

Is Implantable Collamer Lens (ICL) surgery painful?

The surgery itself is relatively short, safe, and usually painless as a lot of anesthetic drops are used to completely numb your eye before the procedure. In very rare cases, sedation or general anesthesia is given to the patients that put them to deep sleep, experiencing no pain or discomfort throughout the procedure.

How long does it take to recover from Implantable Collamer Lens (ICL) surgery?

Recovery from ICL surgery usually happens more quickly than laser eye surgery. The actual procedure takes about 20 to 30 minutes per eye. After the ICL procedure, the ophthalmologist will closely monitor your eyes in the recovery area for a few hours to make sure the artificial lens is sitting properly. In addition to topical steroid eye drops for two to four weeks, your eye doctor will also prescribe antibiotic eye drops for roughly a week. Being an outpatient treatment, ICL surgery allows you to leave the hospital the same day.

You'll probably notice that your eyesight is a little blurry right after surgery and for a few days after treatment. However, some ICL patients return to work after 1-2 days of surgery, so it really depends on your personal recovery timeline. In the initial days, you might also have some blurry vision and a mild sore or irritated feeling in your eyes, but this is totally normal. For the first day or two, it is advisable to stay away from digital screens and bright lights, which also means wearing sunglasses and taking more naps than usual. Additionally, you will be given eye drop instructions to help with your recovery.

Following your treatment, you will visit a doctor for four checkups at the following stages:

  • After 1-2 days
  • After 7–10 days
  • After 4-6 weeks
  • After 3 to 6 months

If your eyesight is clear and the optometrist is satisfied with your recovery and overall outcome, you will be released from the hospital. The eye surgeon will again conduct an examination to assess the situation at the follow-up appointment the following day. Following ICL surgery, there are additional follow-up appointments at one and six months, the year of surgery.

What are the side effects of Implantable Collamer Lens (ICL) surgery?

ICL surgery has been proved to be safe, although it could result in consequences like these;

Implantable Collamer Lens (ICL) surgery Aftercare

  • Your healthcare professional will provide you the following instructions as you recover at home;
  • Avoid strenuous or stressful activities such as weightlifting, contact sports, etc. for 48 hours
  • Avoid digital screens and bright lights for the first day or two
  • Avoid rubbing your eyes 3 to 5 days after surgery
  • Take your prescribed antibiotic and anti-inflammatory drops timely to help in recovery
  • Wearing sunglasses when go out
  • Take more naps than usual to give your eyes some rest
  • It is recommended not to drive until you have been advised by your healthcare professional.

Conclusion

Implantable Collamer Lens or ICL surgery helps you get rid of your glasses or contact lenses by improving your eye vision. The procedure typically lasts 30 minutes, and recovery is swift. Although the operation is permanent, the lens could also be removed if required. As ICL surgery isn’t for everyone, you need to discuss your options with your ophthalmologist. The doctor will take into account your age, eye health, and medical background while recommending an ICL surgery.

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Written ByDrx Hina FirdousPhD (Pharmacology) Pursuing, M.Pharma (Pharmacology), B.Pharma - Certificate in Nutrition and Child CarePharmacology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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