FAQs – Implantable Collamer Lens (ICL) Surgery

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What is ICL Surgery?

ICL stands for Implantable Collamer Lens. It is a form of refractive vision correction which leaves the cornea completely intact and corrects any refractive error by means of an artificial lens which sits behind the iris and in front of the natural lens of the eye.

How does ICL surgery work?

During ICL surgery, a small wound about 3mm is created with a sharp blade. Through this wound, the ICL is inserted into the eye and the legs of the lens is then tucked behind the iris. This lens is customised to each individual, correcting any myopia (short-sightedness) and astigmatism.

What are the benefits of ICL surgery?

Benefits of ICL surgery include:

  • Freedom from glasses and contact lenses
  • No risk of flap related complications e.g. Flap dislocation, flap striae, epithelial ingrowth
  • Tissue saving as the cornea is completely left intact
  • May be more suitable in patients with thin corneas
  • May be more suitable in patients with high myopia
  • May have less dry eyes compared with other means of laser vision correction
  • ICL surgery is reversible

Who is a good candidate for ICL surgery?

A thorough assessment should be done before proceeding with any laser vision correction. In general, a suitable candidate for ICL surgery includes patients who:

  • More than 18 years old
  • Healthy corneas
  • Stable vision and refractive errors
  • Keen to be free of glasses or contact lenses
  • Keen to avoid complications related to PRK/LASIK and SMILE procedures
  • Adequate space in the eye to accommodate the ICL

What can you expect with ICL surgery?

ICL surgery is quick, taking about 10 minutes per eye. Recovery is generally comfortable with minimal discomfort. Antibiotic and steroid eye drops are given after ICL surgery for about a month to prevent infection and minimise inflammation. Many patients are able to return back to normal activities in 1-2 days.

What are the risks of ICL surgery?

Risks of ICL surgery include:

  • Glare and halos
  • Vision fluctuation
  • Under or over-correction
  • Infection
  • Glaucoma
  • Cataract

When can i go back to work? How much leave do i need to take?

Recovery from ICL surgery is quick with minimal downtime with many returning to work in 1-2 days. It is important not to rub your eyes during this early recovery period. A medical certificate is issued cover any absence from work after SMILE surgery.

When can i go back to exercising?

During each follow up consultation after ICL surgery, the recovery process is assessed and advise given on when returning to exercising is suitable. Most patients are able to return to running, jogging and gyming within a week. Swimming should be avoided during the early recovery period.

Is ICL surgery painful?

ICL surgery itself is painless due to the numbing eye drops given before surgery begins. After ICL surgery, there may be some discomfort immediately after the procedure, this largely resolves by the following day.

What are the chances of being glasses free after ICL surgery?

Significant improvement of vision is expected after ICL surgery compared to the previous unaided vision without glasses or contact lenses. About 99% will no longer need glasses or contact lenses to meet legal requirements for driving.

What if I move or blink during ICL surgery?

Gentle blinking during ICL surgery is acceptable as long as there is no effort to tightly squeeze the eyelids closed. There should not be violent or large head movements as this can cause complications like damage to the cornea or the natural lens of the eye.

What precautions do I need to take after ICL Surgery?

After ICL surgery, it is important to avoid eye rubbing and to keep the prescribed eye drops going as planned. Avoid any form of eye trauma and direct contact of water into the eyes.

Can ICL surgery treat astigmatism?

ICL surgery is able to treat high degrees of myopia (short-sightedness) and astigmatism.

Can ICL surgery treat presbyopia (lao hua yen)?

There is a role for ICL surgery in treating presbyopia and achieving glasses freedom. This is in the form of monovision where one eye is corrected for distance vision and the other eye corrected for near vision. Patients may simulate this with a trial of contact lenses before undergoing ICL surgery.

What happens during an assessment for suitability for ICL?

During an assessment, a detailed history will be taken from you and specialised test to gather data on suitability will be done. This includes checking your visual acuity, refraction, cycloplegic refraction, corneal thickness, corneal topography, pupillometry, anterior chamber depth, white to white, eye anterior segment examination, dilated fundus examination. Based on the assessment results, Dr Val Phua will then have a detailed discussion on the various options for laser vision correction and recommend a suitable treatment to meet your vision goals.