Author: Dr Val Phua MBBS, MMed (Ophth), FRCOphth, FAMS
Photo by: Alexandru Zdrobău
ICL (Implantable Collamer Lens) surgery is gaining popularity as an option to correct refractive errors and to be free of glasses or contact lenses. What happens before, during and after ICL surgery? Here is an outline of what you can expect to go through.
Pre-surgical assessment
The assessment for suitability for ICL surgery is an extensive one. You should not be expecting to drop in for a quick 5 minute consult before proceeding to decide on the treatment needed. Be prepared instead to be in the clinic for about 2 hours. During this time, a thorough history will be taken from you including any significant medical issues or previous eye conditions that may make you less suitable for ICL surgery. Your eye surgeon will also perform a detailed eye examination to look for any eye diseases which can affect outcomes of surgery, including presence of keratoconus, glaucoma and retinal pathology. Some time will also be spent performing specialised tests to look at finer details of the eye which cannot be assessed by the naked eye, including the curvature of the cornea, corneal thickness and the amount of space in the eye for the implantable lens. In addition to the above, a trained optometrist will check your best corrected vision and the appropriate prescription you need to see well. Special eye drops are also given to make this assessment more accurate; these eye drops causes a blur for near tasks which will return to normal after 4-6 hours. During this time, driving is generally not advised. Detailed calculations are done to determine the exact lens that your eye needs to correct vision. This includes the exact orientation the lens needs to be placed to correct any astigmatism in the eye.
The day of surgery
As the day of your surgery arrives, many will feel a mix of hopeful anticipation as well as anxiety. Remember that you should not be wearing contact lenses in the lead up to this point. Turn up at your appointed time slot in comfortable clothes and although the procedure itself is quick, you should set aside about 2 hours for the entire process. There are no restrictions on food and drink prior to the procedure. It is also prudent to make arrangements for transport home after the procedure. Before entering the laser suite, your eyelids and lashes will be cleaned and antibiotic eye drops will be given.
Numbing eye drops are given to make you comfortable throughout the procedure, and the eyelids are held open with a small clip. The eye is prepared for the lens insertion with a couple of small wounds (About 3mm) made with a sharp blade. This process is entirely painless so not to worry. Once ready, the lens is then injected into the eye and the legs of the lens tucked behind the iris. With the aid of specialised machines which track any torsion of the eye, the correct orientation of the lens is again checked and ensured.The steps are then repeated for the other eye.
The post surgery care
Some mild discomfort and a foreign body sensation is common in the early post-operative period so don’t be alarmed if you feel as if there is something in your eye. Some may also find the eyes more sensitive to light and will be more comfortable with sunglasses. Symptoms of halos are also common during this early days but they tend to subside with time. Antibiotic and steroid eye drops are given for about a month to prevent infection and aid healing. Most patients experience minimal discomfort with some even going back to work the very next day. In the first week of recovery, avoid rubbing your eyes and vigorous exercise. Other activities like swimming and even diving can be safely resumed after 1 month of recovery. During this early phase of recovery, it is common to experience dry eye symptoms. Use the lubricating eye drops liberally to minimise discomfort.
Overall, the procedure is fast and safe especially if selection of patients is done with care and appropriate steps are taken to ensure success during the surgery as well as post-operatively. Book a consultation to see if this procedure is suitable for you.
