Is ICL A Replacement For LASIK?

With the advent of advanced technology in refractive surgery (the specialty in Ophthalmology that helps people get out of eyeglasses and contact lenses), patients now have several options from which to choose.

One of the more recent Food and Drug Administration (FDA) approved procedures in refractive surgery is the Implantable Collamer Lens (ICL). The addition of ICLs into the field of Refractive Surgery has expanded the range of patients who qualify as good candidates for vision correction. ICLs now allow more patients to potentially lessen or eliminate their dependence on eyeglasses and contact lenses than ever before.

Currently in the United States, ICLs are approved by the Food and Drug Administration (FDA) to treat very high levels of nearsightedness. From the more moderate amount of 3 diopters of nearsightedness, all the way up to the extreme amount of 20 diopters of nearsightedness. By comparison, LASIK is approved by the FDA to treat only 14 diopters of nearsightedness.

When considering an ICL in lieu of LASIK surgery, there are several factors to consider. As with any procedure, the most important consideration is what is in the best interest of the patient. Most doctors view an ICL only as an alternative for patients who are not ideal candidates for LASIK, mostly because of the invasive nature of an ICL procedure verses LASIK. It is important that every patient’s situation be reviewed by a qualified doctor. The pros and cons of each patient’s situation should be discussed by the doctor and their patient.

During the ICL procedure, a permanent collamer lens is inserted inside the eye and secured in place behind the iris and in front of the natural lens. This lens is small, much smaller than a typical contact lens. The patient does not need to adjust it or ever remove it for cleaning.

To insert the ICL, the surgeon must obtain access to the inside of the eye to permanently place the ICL. This intraocular access means that there is more risk for serious infection than in a LASIK procedure.

When the ICL is inserted inside the eye, there are four primary complications that can occur:

  • The patient’s own natural Crystalline Lens of the eye could be “nicked”. This may promote the development of a cataract on the patient’s Crystalline Lens. The treatment for this is cataract surgery.
  • The Iris can be “nicked”. This may cause a permanent irregularity of the pupil which could increase light sensitivity.
  • The back of the cornea can be “nicked”. This could result in endothelial damage which can lead to corneal swelling.
  • The ICL could block the aqueous flow inside the eye. This may cause increased intraocular pressure which could lead to glaucoma.

Due to these intraocular risks (that do not exist in a LASIK procedure) most doctors believe that when a patient is a candidate for LASIK, the safety profile is usually more advantageous then pursuing the ICL alternative. ICLs have their place in the field of refractive surgery; however, for the foreseeable future, LASIK will most likely remain the most commonly performed and more affordable procedure for those who qualify for surgical vision correction.