Not a candidate for LASIK or PRK? You have options!

October 1, 2020

Implantable Contact Lens (ICL) surgery is an alternative way to achieve 20/20 vision for those who may not be good candidates for laser in-situ keratomileusis (LASIK) or Photorefractive keratectomy (PRK) surgery. Like LASIK and PRK, ICL surgery can correct myopia or astigmatism, this is done by implanting a contact lens into the eye. This does not remove or replace the natural lens, instead the implanted lens works in tandem with the natural lens.¹

You may want to consider ICL if…

1. You have too high of a prescription for LASIK or PRK.
2. You have a thin cornea.
3. You have an unstable cornea. Performing LASIK on an unstable cornea may lead to ectasia; weakening of inner layers of your cornea, causing the cornea to change shape, protrude forward and distort your vision.
4. You have already had previous refractive surgery. Once you get LASIK, you can’t get LASIK again. You can, however, get PRK or ICL. Opting for ICL allows for patients to correct vision that has deteriorated after LASIK.
5. You play contact sports or in a career that requires contact with the face.

LASIK and PRK are much more commonly performed but there are some significant benefits to undergoing ICL surgery instead of LASIK or PRK surgery^2,3:

1. It is reversible! A new version of Visian ICL offers a solution to that problem by allowing you to replace the implanted lens if needed, adjusting the prescription like contact lenses by replacing the lens.
2. No removal of tissue. Instead of using a laser to remove and reshape the cornea, a lens is implanted in to work in conjunction with your current vision.
3. Less risk for dry eyes, you may opt for ICL because dry eye is often further exacerbated by LASIK and PRK as they are more invasive procedures. For more information on dry eyes, check out our blog post LASIK and Dry Eyes

The preparation and surgery for ICL is a longer process compared to LASIK, it is important to note and prepare accordingly. Similarly to LASIK, your eye surgeon will ask you to stop wearing contacts for at least 2-3 weeks before surgery. About 2 weeks before surgery, two small pupil openings are made with a laser to allow fluid to flow from the back of the eye to the front of the eye, reducing the pressure from fluid build-up. A small incision is made and the lens is implanted. Ensuring the lens is in place and properly focused does require for the surgery to take slightly longer than LASIK².

There is always a risk for all surgeries; LASIK, PRK, and ICL all have their risks. The biggest risk found for ICL is that the lens may rotate, typically this does not have much of an impact and the lens can be adjusted. As with LASIK and PK, there is a higher risk of infection, night halos, under or over correction, etc². Make sure to discuss the surgery with your doctor, you’ll want to weigh the pros and cons to see which refractive surgery is the best fit for you and your lifestyle.

References

1. American Academy of Ophthalmology. 2020. Alternative Refractive Surgery Procedures. [online] Available at: <https://www.aao.org/eye-health/treatments/refractive-surgery-alternative-procedures>
2. NVISION Eye Centers. 2020. ICL Surgery: Costs, Side Effects & What To Expect | NVISION Eye Centers. [online] Available at: <https://www.nvisioncenters.com/laser-surgery/icl/>
3. U.S. Food and Drug Administration. 2020. When Is LASIK Not For Me. [online] Available at: <https://www.fda.gov/medical-devices/lasik/when-lasik-not-me>

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