Today, I would like to share with you the considerations for ICLV4c implantation surgery. According to the questions that people usually ask, we will summarize them and hope you will read them carefully.
1. Initially determine whether you are suitable for ICL V4c implantation surgery
If you are considering ICL V4c implantation surgery, you should first determine whether your basic conditions are compatible with.
(1) Age: 18-55 years old. The best age is 21-45 years old. If the degree is already stable at the age of 18-21 years old, it can also be done. 45 years old or above can also be operated if the myopia is high and there are no eye problems such as cataracts.
(2) Myopia: ICL V4c lenses are available from 50 degrees to 1800 degrees (the sum of myopia and astigmatism does not exceed 1800 degrees). If the myopia exceeds 1800 degrees, it is possible to correct 1800 degrees with ICL V4c implantation surgery, residual degrees with glasses or combined keratoconus surgery (femtosecond laser and excimer laser type surgery, including superficial TransPRK surgery, femtosecond laser LASIK surgery and full femtosecond laser SMILE surgery.
(3) The refractive error in the past two years is relatively stable, and the change in refractive error within two years should preferably be within 100 degrees. Many people with high myopia may not be adequately corrected by their usual prescription, and there are many people who are not completely sure about their own prescription, so it is also necessary to make a comprehensive judgment based on age and optometry.
(4) When doing pre-operative examinations, if you usually wear contact lenses, you should stop wearing them before surgery: 1 week for soft contact lenses, 3 weeks for rigid RGP, and 3 months for OK lenses. The specific situation can also be determined by the doctor according to the specific situation of each person’s eyes.
(5) No organic diseases and no active inflammation in the eye.
(6) Physical health, no serious diseases, mental health.
2.Go to the hospital for pre-operative examination and evaluation
After the initial judgment that your eye condition is within the scope of surgery, you can prepare to go to the hospital for examination.
(1) A comprehensive examination before surgery is very important. If you are interested in having ICLV4c implantation surgery and basically meet the above conditions, you can prepare to go to the hospital for a comprehensive examination. The comprehensive examination includes comprehensive optometry, dilated fundus examination, corneal topography, corneal thickness measurement, anterior chamber depth measurement, corneal diameter measurement, UBM examination, etc.
(2) The examination usually takes more than 2 hours, so allow enough time.
(3) The fundus examination and optometry require dilated pupils, so you must not drive or ride your own car when you go to the hospital for the examination. It is recommended that you take the subway or a taxi.
(4) Many eye examinations require the removal of contact lenses, so you must remove your contact lenses before the examination. It is best to come to the hospital 1 week after removing your lenses, but if it is too late, you should not wear your contact lenses at least on the day of the examination. Considering the accuracy of some test results, the examination may need to be spread out over two days, so please make a good schedule if you are coming from out of town. If all the examination results are good on that day, the doctor can consider booking the lens directly after comprehensive judgment. If some results need to be reviewed, you may need to come back the next day or later to check some content.
(5) About the examination cost: It includes routine examination of visual acuity, intraocular pressure, optometry, corneal topography, etc. Some of the special examinations related to ICL V4c, including eye ultrasound, IOLMaster measurement, corneal endothelial cell count, etc., may be slightly different depending on each person’s eye condition, and the examination cost is around 200-400 RMB. In addition, blood draws, chest X-ray, ECG and other tests are required before surgery, and the total cost may be around $500.
3.Scheduled crystal and waiting for surgery
(1) After all the examinations are completed, we will calculate the parameters of the ICL V4c IOL based on the examination results and reserve the lens.
(2) A deposit of 5,000 RMB per eye is required to reserve the lens, and the deposit will be calculated into the cost of the surgery. If the patient is unable to come for surgery due to unilateral reasons, the deposit is non-refundable. This will be informed when the deposit is paid.
(3) Waiting time for lenses: ICL V4c lenses for simple myopia are usually in stock and can be delivered to the hospital in a week’s time, and surgery can be scheduled soon. For lenses for myopia combined with astigmatism, Shanghai has less stock and usually need to be imported from Switzerland, if Switzerland has stock, the waiting time is about 2-3 weeks, if Switzerland does not have stock, it may take 6-8 weeks to be delivered, or even longer. The delivery time of the crystal is determined by the stock of the crystal and the speed of logistics, and it is useless to rush the hospital.
4.Pre-operative preparation
(1) After the crystal arrives, the hospital staff will notify the patient and determine the surgery time by combining the doctor’s surgery schedule with the patient’s own time.
(2) Before the surgery, you need to stop wearing contact lenses and apply antibiotic eye drops according to the doctor’s prescription. Generally apply levofloxacin eye drops 4 times a day for 3 days.
(3) Please wash your hair, take a shower, cut your nails and do your personal hygiene the day before the surgery.
(4) Please do not wear makeup or perfume on the day of surgery.
(5) On the day of surgery, it is recommended to wear loose clothing, especially not pullovers with tight necklines or hoodies.
(6) It is recommended that you do not wear high heels on the day of surgery because on the day of surgery, you may not be able to see clearly and it may be inconvenient to walk in high heels. To ensure normal operation of the equipment, the temperature in the operating room is usually low, so do not wear too little in summer to avoid getting cold.
(7) If you have a cold, fever or other physical discomfort before surgery, please inform the doctor so that the surgery can be reasonably arranged.
(8) Female patients during menstruation usually do not affect the surgery, but they need to inform the surgeon.
(9) Regarding whether or not to be hospitalized: arrangements vary from hospital to hospital. We usually arrange hospitalization for post-operative observation. It is best for out-of-town patients to stay in the hospital, or you can arrange for a relative or friend to accompany you to the hospital. If you do not like to stay in the hospital at night, you can also go home, but you must complete the IOP measurement for the day and get permission from the doctor before going home.
(10) About the schedule of double eye surgery: I usually operate on alternate days, that is, I do one eye on the first day and the other eye on the second or third day. Unless there are special circumstances, it is not recommended to do both eyes on the same day.
(11) About the cost of surgery: about 14,000 RMB for one eye, and 17,000 RMB for one eye for those with astigmatism. Hospitalization and basic medication are included.
5.Cautions during surgery
The patient’s cooperation is needed during the surgery, and the patient’s degree of cooperation will play a very important role in the outcome of the surgery. The following points should be noted during surgery.
(1) The entire procedure takes only a few minutes, and there will be light shining on the eyes during the surgery. It is most important to relax, not to be nervous and to listen to the surgeon. Keep your eyes open during the entire surgery, do not blink or turn your eyes at will.
(2) On the operating table, keep your hands on your sides or on your chest and do not touch the sterilized area of your face without permission. If there is any discomfort, inform the doctor and do not move around by yourself.
6.Cautions after ICL V4c implantation
(1) Gauze and eye shield will be covered after surgery, so be careful not to touch around the eyes with your hands. Generally, the eye shield will be opened 2 hours after surgery to measure the eye pressure and review the eyes.
(2) For a few hours after surgery, symptoms such as tearing, photophobia, and foreign body sensation in the eye may occur. At this time, you should wait for the tears to flow out and wipe them on your face, and do not touch the eye directly with tissues or towels. At the same time, you should try to close your eyes and rest, and do not forcefully turn your eyeballs or rub your eyes. Most patients’ eye discomfort can be relieved within 1 day.
(3) Some patients may find localized redness in the white eye after surgery, which may be due to postoperative subconjunctival hemorrhage, which is a normal postoperative phenomenon, the severity and duration of which varies from person to person.
(4) After surgery, you should take medication as prescribed by the doctor, avoid eye trauma, and prevent foreign bodies from entering the eye. Avoid splashing water into the eye when washing your face or hair. Do not apply eye makeup for 1 week after surgery.
(5) After surgery, you still need to pay attention to eye rest and not to use your eyes too much. In the early postoperative period, the quality of vision may not be good in the near and dark light, so try to choose a room with good light to read books and computers, do not look at computers, cell phones and TV continuously for too long, and do not play games.
(6) Some patients, especially those with high myopia, may experience symptoms such as glare and halos after surgery and are advised not to drive at night. These symptoms usually get better on their own after a few months and there is no need to worry. Daytime driving is generally unaffected.
(7) You can wash your face, shower and hair normally on the second day after surgery. A few days after surgery, you can participate in general sports activities, including running, badminton, yoga and using general fitness equipment for exercise, as long as you pay attention to avoid touching your eyes. Please do not swim for 1 month after surgery, and try not to participate in basketball, soccer and other ball games. There are no special requirements for diet after surgery. You can use your eyes the day after surgery, just don’t look at the computer and cell phone too much.
(8) The visual acuity achieved after surgery depends on each individual’s eye condition, and will usually meet or exceed the preoperative corrected visual acuity of glasses after surgery. However, because many people are highly myopic and have poorly corrected vision, their post-operative vision may not necessarily reach a normal vision of 1.0.
(9) After surgery, you need to follow the doctor’s prescription for review, usually 1 week, 1 month, 3 months and 6 months after surgery. It is also recommended to review once a year afterwards.
7.Medication after ICL V4c implantation
The medication for my post-operative patients is relatively simple and generally requires the following medications.
(1) Demerol eye drops: 4 times/day; 1-2 weeks of continuous medication.
(2) Artificial tears: recommended 4 times/day for 1-6 months
(3) IOP-lowering drugs: according to the patient’s specific situation, follow the doctor’s prescription.
Special note: The above medications are basic medications, the specific medications for each patient may be different and should be adjusted according to medical advice.
Extra: Post-refractive surgery precautions
People often ask me: Can I eat seafood after myopia correction surgery? Can I smoke? Can I wash my face? And so on and so forth. Here I would like to give a unified response: after refractive surgery, there are no special contraindications to life, and you can live normally soon after surgery. I would like to briefly summarize the precautions for life after refractive surgery (including full femtosecond SMILE surgery, femtosecond laser LASIK surgery, superficial TransPRK surgery, superficial LASEK surgery, ICL V4c lens implantation surgery, etc.).
(1) Avoid activities that may harm the eye: After surgery, the eye is in the wound recovery period, so try to avoid eye trauma. ICL implantation surgery, an incision will be made at the edge of the cornea, and if there is a large trauma to the eye, wound dehiscence, iris prolapse, and crystal displacement may occur. Although the probability of these conditions occurring is very low, they can still happen. It takes several months for the wound to heal after surgery, so try not to participate in activities such as swimming, basketball, or diving for at least the first month after surgery. We have seen people in the clinic who have had problems with their wounds after surgery due to fighting. Of course, with full femtosecond smile surgery or surface cutting (TransPRK or LASEK), the risk of wound changes due to this type of trauma is minimal, but it is still generally recommended to try to prevent eye trauma for the first month after surgery. High myopia itself has a longer eye axis and the possibility of retinal detachment is also more than the average person, so avoiding eye trauma is also important for fundus disease.
(2) Avoid foreign objects entering the eye: When the corneal wound is not completely healed, if a foreign object enters the eye, the probability of infection or causing eye damage will also be higher. If you go out, you can wear sunglasses or special post-operative protective goggles to avoid dust from falling into the eyes. In addition, some eye makeup, such as mascara, may also enter the eye due to improper handling, so it is recommended to use mascara etc. with caution after surgery. General moisturizing eye creams, which can be used, but eye creams used with heavy make-up, should also be used with caution. Facial use of various skin care products (toners, creams, etc.) generally do not enter the eye, and can be used normally the day after surgery. General facial makeup, including the use of foundations, etc., is also fine as long as care is taken not to allow the makeup to enter the eye. It is recommended not to wear corneal contact lenses such as contacts after surgery.
(3) Body cleanliness: In general, you can wash your face, shower and hair normally the day after surgery, as long as you pay proper attention and do not touch the area around your eyes vigorously and do not allow unclean water to enter your eyes. Some people are so careful after surgery that they have to go to the barber store to wash their hair and dare not wash it themselves, and some even dare not wash their face for a week, which is totally unnecessary, and we have never seen any damage to the surgical wound caused by washing the face and bathing and washing the hair in the clinic. In addition, in the bath, sometimes it is indeed difficult to avoid some water into the eye, generally do not need to panic, we use the flow of water itself is relatively clean, generally will not cause infection and other problems, after the bath can point artificial tears and antibiotic drops to relieve eye discomfort and prevent infection.
(4) Eye requirements: Pay attention to the use of the eyes not to be too fatigued, and use the eyes gradually, but not so much as to prohibit the use of computers and cell phones. No matter which type of surgery is done, the recovery of vision after surgery actually takes some time. Although many patients can already see 1.0 vision after one or two days after surgery, the quality of vision is definitely different from the normal state in the early postoperative period. It generally takes 3-6 months for the visual quality to fully recover after surgery. After myopia surgery, many people find it easier to see close up and get tired, especially when looking at cell phones and computers. We generally recommend to use cell phones and computers as little as possible after surgery, and to turn on the lights a little brighter when reading or watching TV at night. Nowadays, most people cannot work and live without computers and cell phones, so it is impossible not to use computers and cell phones at all. It is generally recommended that according to your own situation, you should still use the computer you need for work, and try not to play games or look at WeChat for too long, etc. Some parents may ask their children to completely prohibit the use of computers and cell phones after surgery, which is generally not necessary either. Some jobs, such as graphic design, finance, etc., use the computer for a long time and look at a relatively small font, which may have some impact on the post-operative work. If you can take some time off from work, it is of course better, and if it is not convenient to take time off, you can also adjust the intensity of work appropriately. If the intensity of the use of the computer at work is not too great, then you can generally go to work normally.
(5) Diet: Generally speaking, refractive surgery does not have any requirements for postoperative diet. Some patients’ parents often ask if they need to “avoid eating” after surgery, but in fact, Western medicine itself does not pay attention to “avoid eating”, and you can eat normally after surgery. I generally recommend following the usual diet, reducing spicy and irritating foods, and reducing foods that may cause allergies and digestive problems, which is also possible, but there is no need to purposely “avoid” food. Some patients or family members are more cautious, asking one moment, “Can I eat seafood after surgery?” A little later, they ask, “Can I eat chili peppers?” and a little later, “Can I eat eggs?” I hope you will remember that if the doctor does not give any special instructions after surgery, just choose the food according to your own eating habits, and do not ask the doctor about each specific food one by one.
(6) Lifestyle habits: smoking, alcohol consumption, sex life, physical exercise, special dietary preferences and lifestyle habits. Doctors generally do not recommend prohibiting something if there is no possibility of direct damage to the eyes. Some people ask, “Doctor, can I smoke after surgery?” This is a difficult question for the doctor to answer, and it is impossible for any doctor to tell a patient, “You can smoke. Smoking is definitely not good for your health and can be a bad irritant to your eyes, but that’s not to say that smoking after myopia surgery can cause serious damage. If you usually like to smoke and are unable to quit, it is unlikely that smoking will cause significant damage to your eyes after surgery. Physical exercise, as long as it does not touch the eyes, will not have a significant impact either, such as running or exercising muscles in the gym, are unlikely to touch the eyes and can be done normally. Sweat flowing into the eyes will also stimulate the eyes, so you can pay a little attention to it, and a little artificial tear solution after exercise is also beneficial.
(7) Postoperative medication: This was not part of this topic, but some patients asked about it, so I added it to this article. I personally do not advocate the application of too many drugs after surgery. In general, some antibiotic drops (to prevent infection) and corticosteroid drops (anti-inflammatory, to prevent complications) are required after surgery, but they should not be used for too long. The other type of drugs is artificial tears, which can be applied according to each person’s specific situation, and can be used for 1-6 months. It is recommended to use some clinically proven drugs, such as Siran (Alcon), Ally (Genten), Rexin (Allergan), and some biologics to promote corneal healing in the early post-operative period, which are now mostly used with calf serum gel (Speedy Gogol). These drugs usually need to be dispensed in the hospital, and some of the larger pharmacies can also buy them. In addition, some of the “anti-fatigue” eye drops that are often advertised on television are generally not recommended. To relieve visual fatigue, the most crucial thing is to pay attention to the use of the eyes, not the use of drugs. People often ask me if I can use a certain kind of eye drops, because I can’t be familiar with every kind of eye drops, and I don’t dare to jump to conclusions.
In short, after refractive surgery, you can soon live and work normally. The main thing in the early post-operative period is to pay attention to not overworking the eyes and avoiding direct trauma to the eyes. Other lifestyle habits generally have little effect on the surgery.