Please click on the below questions to view the answers.
Implantable Contact Lens
Ans. Candidates for the ICL are between 21 and 45 years of age, suffer from myopia (nearsightedness), hyperopia (farsightedness) and/or astigmatism (cylindrical power) and want to experience superior vision correction. The ideal ICL candidate has not undergone any ophthalmic surgery (though your surgeon might opt to do it as a secondary procedure in certain select cases) and does not have a history of eye disease such as iritis, glaucoma, or diabetic retinopathy. Nearly anyone seeking clearer vision may be a ICL candidate, including those with special or extreme vision correction needs. Prospective person should consult his/her ophthalmologist (eye surgeon) for more information, including an assessment of their candidacy. Women who are pregnant or nursing should wait to have the ICL implanted. Lastly, those without a large enough anterior chamber depth or endothelial cell density may not be a good ICL candidate.
Ans) Quite common. For those found unsuitable for LASIK (varies between 10 to 15% of cases seeking LASIK at our centre). Dr Anand Shroff is a very meticulous surgeon. He does not take an iota of chance on any patient whom he feels LASIK is unsuitable for. ICL is a simple procedure. Best part is that it is reversible for any reason, however, till date we have not needed to remove an ICL because a patient was dissatisfied.
Ans) As we never perform ICl on both eyes in the same sitting, we need a day’s gap. The inpatient time in the hospital on the day of the procedure is about 2 hours, but actual procedure time is not more than 20-25 minutes.
Ans) If ICL is planned on Tuesday for first eye, then post ICL we need to see on the next day i.e Wednesday afternoon. We can plan second eye procedure on Thursday. (Pls note that Tues and Thurs are the days for ICL procedures in our centre at Bandra). Then second eye post ICL check is scheduled for Friday afternoon. You need to be in Mumbai for at least 2-3 more days and see Dr Shroff once before flying out. There are no mandatory checkups thereafter, but if in Mumbai, we ask them to see him after 3 months.
Ans) The best quality lenses so far used are from Visian STAAR company. In this there are 2 types- Spherical and Toric. Few cases need Toric ICL, and this would be discussed with you after the entire evaluation with Dr Shroff.
Ans) One almost never needs to remove these lenses. They have a full lifespan. However, if and when a person gets a cataract as they age, then a cataract by itself needs a lens replacement. If this were needed, then the ICL is removed during cataract surgery, as with today’s cataract lenses, even powers are corrected, hence not needing the ICL it gets replaced with the artificial lens during cataract surgery.
Ans) Yes, lenses can be removed. The procedure is reversible. One will go back to needing spectacles or contact lenses if this situation would arise.
Ans. Our fees have been the same in the past many years in spite of a rise in the Euro. Also, the lenses are manufactured in Switzerland specific to your eyes and hence expensive. Unfortunately, we do not price our fees keeping discount margins, so difficult to comply with this.
Ans. This option stays with you as the only possible way to be free from glasses and contact lenses safely for a long time, hence, you may exercise this option anytime in future.
Ans. It is a choice,. It is not a surgery that has to be done. You can continue with your contacts and glasses forever. However, when you come to Dr Anand Shroff, he is a very particular surgeon who does not take any chances, and hence will only offer what is safe and found to be beneficial to you. Hence, he said ‘no’ for LASIK.
Ans. Many of our patients do not even live in Mumbai. Your precautions remain the same irrespective of geographical location. All that is important post ICL is the correct use of eye drops, and so long as you are sincere to use it 4 times a day and can instill it yourself independently, you do not need anyone after the first 24 hours.
Ans. Like I mentioned, comparatively, many are found fit for LASIK in general population. Most have powers less than -10.00 D, if you were to ask around. Very few would be found to have higher powers. Hence, ICL is less heard of. In some cases it is not about the power, but about the cornea that needs to be reshaped. The cornea is the door to the eye, and in trying to remove your entire number, one cannot afford to treat so much cornea in your case, which makes it very thin post LASIK. Hence, one has to be within safety limits. These situations are not as common as those who are found fit for LASIK, hence ICL is less heard of in general population, but all with powers not treatable by LASIK would have known of it.
Ans. There is no complication in your cornea. It is only thinner than what we need for a safe LASIK procedure. You have a choice to stay just the way you are, and that does not mean there is some abnormality or complication.
Ans. LASIK remains the most popular form of laser vision correction. It is a surface treatment, with quick recovery, hence advised as first line of treatment. At our centre, we would advise ICL only in those unfit for LASIK and still looking for an option other than lenses or glasses.
Ans. Yes. However, some who are advised ICL still may not be fit for it, and this we come to know only when we do the A Scan and other tests to determine eligibility of ICL procedure. There are some with shallow anterior chamber etc which makes them unfit for ICL as well. Hence, safety can be determined only after the ICL specific tests, till then, in general, yes it is safe. In all patients that have undergone ICL with us, all are satisfied with no complications
Ans. Regarding the floaters…well, it is in the vitreous jelly, in an area which is separate from where the ICL is going to be inserted. However, after ICL insertion, some find better clarity of vision, which then brings them to notice the floaters which were always there, but now, they notice them more. Floaters usually settle down on their own and need no management. They are more a nuisance value than something to be worried about.
Ans. A trained ophthalmologist will insert the ICL through a small micro-incison, placing it inside the eye just behind the iris in front of the eye’s natural lens. The ICL is designed not to touch any internal eye structures and stay in place with no special care.
Ans. The Toric ICL is a only variant of ICL. Toric ICL corrects your nearsightedness as well as your astigmatism (cylindrical power) in one single procedure. Each lens is custom made to meet the needs of each individual eye.
Ans .Prior to being placed on the market, the ICL was subject to extensive research and development. Today, more than 65,000 patients worldwide enjoy the benefits of the device. In an USFDA clinical trial, over 99 percent of patients were satisfied with their implant. The ICL has a track record of stable, consistently excellent clinical outcomes. The lens has been available internationally for over 12 years.
Ans. No, most patients state that they are very comfortable throughout the procedure. Your ophthalmologist will use a topical anesthetic drop prior to the procedure and may choose to administer a light sedative as well.
Ans. The ICL is made of Collamer®, a highly biocompatible advanced lens material which contains a small amount of purified collagen. Collamer does not cause a reaction inside the eye and it contains an ultraviolet filter that provides protection to the eye. Collamer is a material proprietary to STAAR Surgical Company, the company that manufactures ICL.
Ans. One advantage of the ICL is that it offers treatment flexibility. If your vision changes dramatically after receiving the implant, your doctor can remove and replace it. If necessary, another procedure can be performed at any time. Patients can wear glasses or contact lenses as needed following treatment with the ICL. The implant does not treat presbyopia (difficulty with reading in people 40 and older), but you can use reading glasses as needed after receiving the ICL.
Ans. The implantation procedure for the ICL (Implantable Contact Lens) is refractive eye surgery that involves a procedure similar to the intraocular lens (IOL) implantation performed during cataract surgery. The main difference is that, unlike cataract surgery, the ICL eye surgery does not require the removal of the eye’s natural lens. The ICL procedure is a relatively short outpatient procedure that involves several important steps. The surgical procedure to implant the ICL is simple and nearly painless. As a ICL candidate, your doctor will prepare your eyes one to two weeks prior to surgery by using a laser to create a small opening between the lens and the front chamber of your eye (iridotomy). This allows fluid to pass between the two areas, thereby avoiding the buildup of intraocular pressure following the surgery. However, some surgeons choose to do this step on the same day of the surgery. The implantation procedure itself takes about 15-30 minutes and is performed on an outpatient basis, though you will have to make arrangements for someone to drive you to and from the procedure. You can expect to experience very little discomfort during the ICL implantation. You will undergo treatment while under a light topical or local anesthetic, perhaps with the addition of a mild sedative. Following surgery, you may use prescription eye drops or oral medication. The day after surgery, you will return to your doctor for a follow-up visit. You will also have follow-up visits one month and six months following the procedure. Although the ICL requires no special maintenance, you are encouraged to visit your eye doctor annually for check-ups following the ICL procedure.
Ans. Although the ICL is intended to remain in place permanently, a certified ophthalmologist can remove the implant in a very quick & short procedure.
Ans. No, the ICL is positioned behind the iris (the colored part of the eye), where it is invisible to both you and observers. Only your doctor will be able to tell that vision correction has taken place.
Ans. The ICL is designed to be completely unobtrusive after it is put in place. It stays in position by itself and does not interact with any of the eye’s structures.
Ans. Please be aware that ICL procedure is presently available at select centres & hospitals in India as it requires precision and skills. In our Hospital, Dr Anand Shroff, our Cornea and LASIK expert will guide you better if you are the right candidate for this procedure.
Ans. The same surety that you could hand me today that your spectacle powers will not change!. Please remember that the eye is an organ not doing static fixed focus work, but something dynamic. If powers shift in adulthood, these are usually not related to the shape of your eyes or measurements taken of the same. These are also largely due to lifestyle, working long hours on the PC, changing the utility of your visual work from computers to movie screens etc. Our duty is to make you aware that doing such activities without proper and necessary precautions will shift your powers slightly (not hugely, but yes, small powers may come into play). This is the reason why we shall insist that you use computer specific prescription when working long hours on the PC, take frequent breaks etc.
Ans. In our experience, we have not seen any adverse effects. Itchiness of the eyes is usually in the eye lids, this part is untouched in ICL or LASIK treatments. hence, if your eyes are prone to turning ‘red’ or getting ‘itchy’ or ‘dry’ this is the inherent nature of your eyes and the procedure does not aggravate or cause this.
Ans. If planned well, no more than 10 days are required for doing ICL as both eyes are not treated on the same day.