Alternatives to Glasses or Contact Lenses. Know your options.

Tired of wearing your glasses or finding contact lenses a hassle with red and dry eyes? What are your options?

Every few years, a ground breaking procedure or product becomes available. PRK prevailed before Lasik and now there is the Implantable Contact Lens (ICL™). In the 1990s, Lasik superseded PRK in terms of quicker recovery and lesser pain. This explains why Lasik has been the most popular procedure done for vision correction. Now there is a advanced alternative to Lasik.

Let me introduce you to Implantable Contact Lens (ICL™)

Beyond Lasik, the Implantable Contact Lens (ICL™) which is the most advanced premium, vision correction surgery is now available in Singapore. Rather than altering the shape of the cornea by thinning the corneal tissue as in Lasik, the ICL™ is placed behind the iris (coloured part of the eye) to enhance the focusing abilities of the eye's natural lens. The cornea where light enters the eye is kept pristine. Should your prescription change, the lens is reversible and replaceable to maintain your vision for years to come.

  

 
Why Choose ICL™?
The Lens centre has chosen to use ICL over laser refractive procedure because of  repeatable, reliable data from research. The stringent Food and Drug Administration (FDA or USFDA) is a government agency of the United States Department of Health and Human Services responsible for regulating and supervising the safety FDA, showed in a 3 year study that ICL is safe, predictable and accurate for the correction or treatment of myopia. The three-year data, based on the assessment of 526 eyes of 294 patients published the  following results:

• 99 % of patients were satisfied/very satisfied with their results.
• 98.3 % of patients had uncorrected visual acuity of 20/40 or better.
• Once vision was corrected, the correction was stable and did not change over the follow up period.
• The incidence of glare, halos, double vision, night vision problems and night driving difficulties decreased or remained unchanged from before surgery.

During clinical trials, researchers compared the outcomes of ICL patients to those of LASIK patients with similar prescriptions. The patients involved in the study were very nearsighted (8-12 diopters of nearsightedness prior to surgery), and their visual outcomes were measured at regular intervals post-operatively.

• The results showed that ICL provided superior post-operative visual acuities when compared with the Lasik population. For ICL patients, 52% of patients demonstrated post-operative uncorrected visual acuities of 20/20 or better, while only 36% of Lasik patients were able to achieve 20/20 vision or better following surgery.
•  Additionally, patients who received the ICL also reported a better quality of vision than those who had undergone Lasik
• I CL has been shown to induce significantly fewer higher order aberrations than Lasik.
• Symptoms such as glare, halos, double vision, night vision difficulty and night driving difficulty were largely absent or mild after 3 years postoperatively.

The ICL has advantages over refractive surgical procedures such as Epilasik and Lasik, and reduces the risk of higher order aberrations compared to standard LASIK.

ICL compares superior to both LASIK and EpiLASIK:

I have attached more research studies which may be of interest to you.

Swiss technology from Staar

“It’s not just about looking better but seeing better’. How many of you see better with contact lenses than with glasses? Its an optical fact that the nearer a vision correction is placed nearer to the sweet spot (nodal point) in the eye, the clearer the vision. That is why implantable contact lens (ICL™) is superior to the popular contact lens placed on the cornea which is in turn superior to glasses.

In a study where patients had LASIK on one eye and ICL in the other, almost all patients preferred the vision in the ICL eye. This is because, optically speaking, the ICL is at the optimal position in the eye
 
So implanting a contact lens would be superior even to wearing contact lenses!”

Now it is possible to achieve High Definition Results without many of the risks associated with LASIK.

Click on the following links and learn the difference:
Refractive Vision Correction Options
ESCRS Presentation, Oct 2006
Modern Medicine, Feb 2008
STAAR Visian ICL Animation
VICL Military
Visian ICL ( Dec 09 )
ICL for Keratoconus
Advantages ICL over LASIKA literature review

There’s a big difference between “visual acuity” (20/20 vision is considered normal visual acuity) and “visual quality’’. The ICL provides vision correction that goes beyond LASIK. It helps you enjoy sharper, clearer, and more vivid vision, with greater depth and dimension.  It’s called High Definition Vision

Why choose the Pacific Implantable Lens Centre?

Choice of Doctor
We have chosen to offer this procedure over laser refractive procedure for all prescriptions because of its advantages. Dr Lee was trained and working in Europe where the lens was first implanted about 20 years ago. Short sighted people have more of a risk of retinal problems than normal sighted people. Dr Cheryl Lee is also a retinal specialist and retinal surgeon so you can be assured that the health of your eye would be thoroughly assessed before any intervention.

Choice of ICL
The ICL is custom made in terms of prescription and size for the individual. To ensure accuracy and predictability of results, Dr Lee works with a team of highly qualified optometrists on site to ensure stability and precision of the optical prescription which is essential for determining the power of the ICL.

To ensure precise sizing of the ICL, Pacific Implant Centre has the VuMax ultrasound Biomicroscope which us the most advanced high frequency ultrasound available today. This is important for
- Anterior chamber depth measurement (adequate space for ICL placement)
- Sulcus to sulcus measurement (accurate sizing of ICL)

High frequency ultrasound technology available today. - the most advanced and versatile high-frequency ultra- the most advanced and versatile high-frequency ultrasound technology available today

What if you are interested?

Part1: We must first find out if you are suitable to have it done.
What makes up the suitability criteria?
Good candidates for the ICL include patients who:
    
Have not had a change in their eyeglass prescription of more than 0.5D in a year.
Have sufficient anterior chamber depth (for placement of the ICL)
Were non-LASIK candidate because of dry eyes, severe myopia, or a thin cornea
Are not currently pregnant.

The ICL corrects all ranges of short and long-sight and even astigmatism so prescription is not a restriction.

1. Four-Year Follow-up of Posterior Cahamber Phakic Intraocular Lens Implantation for Moderate to High
   
   
2. Comparison of Implantable Collamer Lens (ICL) and Laser-assisted In Situ Keratomileusis (LASIK) for Low Myopia
   
   
3. The Star Visian ICL Revolution
   
   
4. ToricImplantable Collamer Lensfor Moderateto High Myopic Astigmatism
   
   
5. Matched Population Comparison of the Visian Implantable Collamer Lens and Standard LASIK for Myopia of 3.00 to 7.88 Diopters
   
   
6. Nine-year Follow-up of a Posterior Chamber Phakic IOL in One Eye and LASIK in the Fellow Eye of the Same Patient

THE ICL™ CAN CORRECT

• myopia up to 1900 degrees
• long sightedness up to 1000 degrees
• astigmatism up to 600 degrees

Part 2: Laser iridotomy
This is done about 5 days prior to the ICL implantation

Laser iridotomy uses a very focused beam of light to create a hole on the outer edge, or rim, of the iris, the colored part of the eye. This opening allows fluid (aqueous humor) to flow between the anterior chamber, the front part of the eye, and the area behind the iris, the posterior chamber. This opening prevents sudden build up of pressure within the eye,

 

Figure 1: In laser iridotomy, a small hole is placed in the iris (the colored portion of the eye). In most patients, the iridotomy is placed in the upper portion of the iris and cannot be seen under the upper eyelid.

How is laser iridotomy performed?
Before having an iridotomy, you will have an eye drop called pilocarpine to make your pupil smaller. This medication may temporarily cause blurred vision and also may give you a brow-ache so I suggest taking paracetamol a few hours before
The only kind of anesthesia required to perform a laser iridotomy is an eye drop. With the eye drop, the laser surgery should be painless. You may see a bright light, like a photographer’s flash from a close distance. Some people feel a sensation of heat in the eye. Otherwise it is comfortable
For the procedure you are seated in front of a machine like the one during the consult clinic. It is relaxed and you are chatting with the doctor.
Your doctor will next place a special contact lens on your eye to focus the laser light upon the iris. This lens keeps your eyelids separated so that you don’t have to worry about blinking or your eye moving during the treatment. A special jelly is placed on the contact lens. This jelly may remain on your eye for about 30 minutes, leading to slightly blurred vision which passes quickly.

What to expect after an iridotomy.
There are no restrictions in activity following the laser treatment. You can return to your normal daily chores immediately. It is advisable to have someone drive you home from your doctor’s office. You might have a small headache because of the pilocarpine eyedrop that constricts the pupil. This  wears off after a few hours.
You will be given eyedrops to use for the next five days

Risks
Do not worry about the size of the hole in your iris. Neither you nor your friends will notice it. It is usually placed in a portion of the iris which is covered by your upper eyelid. The size of the iridotomy is only that of a pin head.
Remember that the creation of a laser iridotomy is both safe and effective. There are a few risks.

• Bleeding. A small amount of bleeding from the iris is quite common and usually stops in less than a minute with brief pressure against the eye.
• Elevated intraocular pressure. Usually transient and brief, a rise in IOP may require additional medication.
• Intraocular inflammation and formation of adhesions between the iris and lens. Anti-inflammatory drops are used post-treatment to avoid this.
• Corneal abrasions can occur during removal of the iridotomy lens. These are painful but heal quickly and are generally benign.
• Halos, glare, double vision. Light passing through the iridotomy may occasionally cause glare or frank double images. The greatest risk of these symptoms occurs when the iridotomy is placed near the upper eyelid margin. Care is taken to place the iridotomy in a position that is well-covered by the eyelid, avoiding these problems.
• Failure to complete the iridotomy. In patients with very thick irides, an iridotomy might not be completed during a single visit. In such cases, a second treatment is performed on another day to finish the procedure.

Part 3: Day of procedure

ICL IMPLANTATION
This takes about 20 minutes and is performed at our own Day surgical centre.

• Dilating eyedrops would be applied before the procedure.
• You have the choice for the implantation to be performed under local anaesthetic eye drops alone or combined with oral or intravenous sedation. For those who prefer you can have it done under general anaesthetic. The procedure is not uncomfortable or painful. This should be decided at time of first consult.
• You will be lying down during the procedure. It is a relaxed atmosphere and you can communicate with the doctor. You will be told to stay fairly still only during certain parts of the procedure.
• You do not have to worry about your eyes blinking or moving during the procedure
• Iodine is used to keep your eye sterile
• A small drape keeps your eye clean
• A small incision is made in the cornea-scleral junction
• The ICL is Inserted of your eye between the iris (the colored part of your eye) and the natural lens
• The small incision acts like a self sealing valve and usually no stitches are necessary
• Following surgery, you will use antibiotic drops for 2 weeks. The day after surgery, you will return to the clinic for a follow-up visit.

Check out what other people are saying about Visian ICL on Facebook! & Implantable Contact Lens on Facebook