Dr. Harold Ridley, an ophthalmologist in London, discovered it was often safer to leave these plastic fragments in the eye than try to remove them. Since the eye tolerated the material with no adverse reactions, he created an artificial lens implant to be placed inside the eye from PMMA—the same form of plexiglas.
However, it was not until the early 1970s that artificial lens implants and surgery techniques developed to the point where the procedure was considered safe and effective. Today, lens implants are made of a number of high tech materials and are routinely used in approximately 3 million Americans who develop cataracts each year.
Unlike lens implants that replace the eye's lens after cataract surgery, ICLs are placed in front of the natural lens. In this position, they work in combination with the eye's lens to add more focusing power. ICLs offer dramatic results that are quite predictable. They are maintenance free and never need cleaning.
ICLs can be used to correct low to very high degrees of nearsightedness between -3 and -20 diopters.
Although ICL surgery is a sophisticated microsurgical procedure, it is relatively simple for those undergoing treatment. Patients relax in a reclining dental-type chair while assistants make sure they are comfortable in preparation for surgery. They are not put to sleep, but can be sedated with oral medications, if necessary. Only the tissue around the eye is numbed for surgery.
The surgeon makes a micro-incision that allows the implant to be inserted behind the cornea. Each lens is specifically selected for focusing power that matches the eye's needs and is carefully positioned. The opening into the eye is very small and heals quickly. One eye is treated at a time in a procedure that usually takes 15 minutes or less.
With ICLs positioned in front of the eye's natural lens, they could restrict the important flow of fluid through the front part of the eye. To prevent this, the surgeon performs a simple procedure called an iridotomy making one or two tiny openings in the periphery of the iris. This may be done during the implant surgery or as a laser procedure during an exam before the lens is implanted.
In most cases, visual recovery is rapid. A few hours after surgery, patients see well enough to perform regular activities with dramatically increased visual freedom. During recovery time, which may take a few days, the other eye provides normal vision. However, if both eyes require correction, vision will be imbalanced until an implant is also placed in the other eye.
ICLs cannot be felt inside the eye and side effects are minimal. But increased light sensitivity can be expected for a few days, so sunglasses may need to be worn more often than usual.
If the visual outcome is not ideal once the eye has healed, a second procedure to adjust or replace the lens is generally possible. Laser vision correction (LASIK or PRK) may be recommended to fine tune the result or correct astigmatism.
In some cases, individuals may need reading glasses after surgery even if they did not need them before.
With age, most people develop cataracts—a clouding of the eye's natural lens. The solution for a cataract is to surgically remove the clouded lens and replace it with a lens implant. During this procedure, the ICL would first need to be removed. A new lens implant would be selected to provide optimal focusing power. Although cataracts may begin to form earlier in life, and surgery is occasionally required for people in their 50s, the average age for cataract surgery in the USA is about 72 years.
If you have questions about this treatment option, talk with your optometric physician or call our refractive surgery counselors.
Pacific Cataract and Laser Institute
Refractive Surgery Counselors
800-884-7254
