The most widely used refractive lens surgery is the ICL toric IOL implant. The principle of the procedure is very easy to understand, it is equivalent to putting a contact lens inside the eye. There are several different brands of IOLs available, but the ICL lens is relatively the best in terms of overall evaluation.
Compared to other IOLs, one of the important features of ICL is that it is made of a very special material, which is Collamer’s patented high-tech material, a collagen-like material that has no rejection in the human body, and is produced by STAAR, a company whose factory is in Switzerland. The current production cycle for this ICL lens is long, so it is possible that patients may have to wait some time after booking before surgery. Especially for lenses with astigmatism, which are usually not available in China and need to be ordered from Switzerland, the waiting time will be longer.
Unlike keratomileusis, the main feature of ICL implantation is the “principle of addition”, which means that the operating room “adds” something to the eye, while corneal surgery is the “principle of subtraction This means that the operating room “adds” something to the eye, while corneal surgery is a “subtraction” procedure. In this way, it is clear why IOL implantation is safe. Theoretically speaking, the “additive principle” surgery room is reversible, and what is put in can be taken out, while the “subtractive principle” surgery is irreversible, and the tissue that is subtracted cannot be restored. Of course, this does not mean that corneal surgery is unsafe. For low myopia, the tissue ablated by the laser is very little, and the corneal thickness remains within the safe range after surgery, so there is no safety problem.
However, for high myopia, if corrected by laser surgery, more corneal tissue is cut. The surgery is designed not to go beyond the safe range. Therefore, for very high myopia, in corneal laser surgery, sometimes the diameter of the optical area needs to be reduced in order to minimize the degree of myopia, in which case, the pupil becomes larger after surgery when the light is darker, and the quality of vision will be reduced, such as driving a car at night, and looking at the lights may cause glare and therefore affect driving safety. The results achieved through ICL implantation surgery are much better. Because the ICL lens is placed directly behind the pupil, the actual quality of vision achieved is superior to that of the optical area of the cornea of the same size.
1. Safety
ICL does not remove or destroy corneal tissue, and is gradually becoming the fastest growing new trend in the world because of its superior results that cannot be matched by laser surgery.
2.Reversible
Unlike contact lenses, ICL crystals can be permanently implanted in the eye. If myopic patients need other eye surgeries, ICL can be removed without causing any structural changes in the eye or cornea.
3. High Definition
The eyes are restored to excellent high-definition visual quality, and the corrected vision can meet or exceed the expected corrected vision before correction.
4. Rigorous
Detailed preoperative testing and preoperative preparation, Swiss precision-tailored crystals, and an international team of VISIAN ICL-certified physicians.
5.Protection
ICL materials contain UV-blocking genes, which can organize harmful UV rays into the eye, thus effectively curbing UV-induced related eye diseases.
6.Comfort
The stable position of ICL in the eye ensures that it works in harmony with your eye. Once the lens is implanted in your eye, not only can you not see but you cannot feel the presence of the lens.
I. The range of ICL can correct
1. If the myopia is relatively low, such as within 600 degrees, and the corneal thickness is sufficient, the ideal visual quality can also be achieved through corneal refractive surgery. Most doctors in China tend to choose laser keratomileusis. On the one hand, the cost of this type of surgery will be significantly lower than ICL implantation surgery, on the other hand, corneal surgery does not require special preoperative preparation, and can even be operated the next day after the examination the day before, while ICL requires a longer waiting time before surgery, and the postoperative review is also more demanding than corneal abrasion laser surgery.
2. If one has astigmatism, ICL cannot correct myopia up to 2000 degrees. Due to the limitation of the production process of the intraocular lens itself, it is not possible to increase the correction degree indefinitely. For example, an eye with 2000 degrees of myopia and 500 degrees of astigmatism. If one chooses a lens with astigmatism, the myopia may only be corrected by 1500 degrees. Of course, this is only an approximate calculation, specifically to each eye, the correction will be somewhat different.
3, then, myopia more than 2000 degrees, is not the surgery can not be? In fact, it is possible to operate and consider undercorrection. For more than 2000 degrees of myopia, which may also be accompanied by astigmatism, we can actually correct most of myopia through ICL, leaving some degrees. The remaining degrees of myopia and astigmatism can be corrected by wearing glasses or through laser corneal surgery.
Second, consider ICL surgery, what conditions are required?
1.Age above 18 years old and below 50 years old. The best age for correction recommended by STAAR is 21-45 years old, but in actual clinical work, it is also decided according to the patient’s condition. My own patients who had surgery, the oldest age is 55 years old, is very high myopia, their own intraocular conditions are relatively good, there is no crystal clouding and fundus disease, the patient itself hopes to improve the quality of life through surgery.
2, myopia is generally recommended -2.0D to -20D, astigmatism ≤ 5D; hyperopia +2D ~ +10D. No history of internal eye surgery and intraocular pigment membrane, retina and glaucoma lesions, and good corrected visual acuity.
3.No abnormalities in the cornea, no abnormalities in the atrial angle structure, and normal intraocular pressure on routine examination.
4, anterior chamber depth ≥ 2.8mm.
5, corneal endothelial cell count >2500/mm.
6, all kinds of laser surgery involved in the high refractive error of the complementary correction.
7, no mental illness, with a reasonable desire to remove the lens and a suitable postoperative expectation mentality.
Third, which cases are not recommended to do ICL implantation surgery?
1.Patients with unstable myopia.
2.Age less than 18 years old or more than 50 years old.
3.The anterior chamber depth ACD <2.8mm (the distance from the corneal endothelium to the anterior surface of the lens).
4, low corneal endothelial cell count, corneal degeneration or corneal endothelial cell count <2500/m.
5, The patient has insulin-dependent diabetes mellitus.
6, Either eye is glaucoma or cataract or diagnosed with high intraocular pressure.
7, The patient has systemic collagen sensitivity or autoimmune disease.
8.Active inflammation or tumor of the eye and ocular appendages.
9.Persons with psychological abnormalities who have not been allowed to operate by a psychological or psychiatrist.
10.Female pregnancy and lactation.
IV. What preparations are needed before ICL surgery?
First of all, a comprehensive pre-operative examination is required. It is recommended to stop wearing contact lenses for 1 week before coming to the hospital for the examination. There are many items to be examined, including optometry, corneal topography, corneal endothelial count, fundus examination, anterior chamber depth measurement, etc. The examination usually takes about 2 hours at least. Because of the dilated pupil examination, you cannot drive on the day of the visit.
After a thorough examination to determine the eye’s suitability for ICL surgery, you will have to come to the hospital at least once more for preoperative preparation. Another eye exam is required to determine the refractive error of the eye and to book the lens. In addition, there is a special pre-operative treatment, which is YAG laser iris punching. This is where a small hole is cut in the iris of the eye by a laser. This is done to prevent an increase in eye pressure. After the iris is perforated, your eyes will be blurry, especially within an hour after the laser is applied. You should also not drive or wear contact lenses that day.
The waiting time after ordering the lens usually takes 4 – 6 weeks. If it is a lens without astigmatism, it usually arrives within 4 weeks. For lenses with astigmatism, the waiting time may be longer because they need to be custom made from Switzerland.
V. Post-surgical considerations
The ICL implantation surgery itself is a very short procedure, usually done within 15 minutes. Within a few hours after the surgery, the eyes can see. However, a quick recovery from surgery does not mean that you can take it lightly after surgery. Post-operative review is very important. It is usually necessary to review the first day, one week, one month, three months, six months, and one year after surgery. In the future, annual review is also recommended. High myopia itself may have some problems such as fundus lesions, so the review is not only for the ICL surgery itself, but also for the overall condition of the eye.