Implantable Contact Lenses

The purpose of the consultation is to a) ensure suitability for Implantable Contact Lens surgery and b) plan the procedure with the absolute correct dimensions and correction. The process involves a very thorough evaluation by nurses, optometrists and technicians who will perform a series of tests and investigations specific for the EVO Visian ICL procedure. These include Specular microscopy to measure the corneal endothelial cell count, anterior segment imaging and biometry to measure the dimensions of  the front of your eye to ensure there is enough space and that the configuration is suitable to receive an EVO Visian ICL. This also helps us determine the size of the implant.

You will be provided further information about the procedure and shown video animations to help understand the process. It is important that you read the consent form as this may generate questions for your surgeon whom you will see next.

Your surgeon, a well experienced fellowship-trained consultant will evaluate your eyes  and evaluate the test results and come to a final decision. The consultant will inform you about your suitability what is involved and what to expect and also provide you with an informed consent.

If you are lucky enough to be suitable for Implantable Contact Lens surgery and wish to proceed, you will need to confirm a date and pay a deposit for the lenses which will have to be ordered from the manufacturer Staar Inc. in Switzerland. If you have astigmatism or keratoconus, special bespoke lenses may have to be made for you and these can take about 6 weeks to manufacture (sometimes longer depending on the prescription).

Implantable Contact Lens surgery can be performed on both eyes on the same day, however your consultant will decide if this is an option for you or not. Your consultant may choose to treat one eye at a time and perform the other 2 days later. On the day of surgery, dilating and strong anaesthetic drops are instilled in the eye, and a sedative is provided either orally or through your veins. The procedure involves folding the lens in a lens insertion device and implanting the curled up lens through a tiny incision (2.8mm). The lens is then positioned behind the iris and rotated into the correct position if an implant for astigmatism is used (Toric EVO ICL). Medication to constrict the pupil may be inserted as well as antibiotics to prevent infection.

One hour later you will be examined to check your vision and pressure. The surgeon will also examine the eye to make sure all is well before you go home. You will be seen again the following day. To help the eye heal, steroid and antibiotic eye drops will need to be taken four times daily decreasing by one drop each week.

You must be seen the day after your operation to ensure all is well. You will be seen again at one month and a series of investigations will be performed to ensure your lenses are well positioned and stable. If felt necessary or if you have any concerns, you can be seen earlier. Vision is typically very good the day after Implantable Contact Lens surgery and improves further with time. The eye drops are very strong and can affect the eye surface causing symptoms of dry eye and may in turn temporarily affect vision. This will improve once the drops are stopped, however it is important that these be used as instructed. You will also be provided with artificial tears to use in case this happens.

While the vast majority of patients are absolutely thrilled with their visual outcome, for a very small number obtaining good vision can be quite a shock and also different from vision with glasses and contact lenses.

This initial change is something that eventually all patients adapt to and are ultimately thrilled with their visual freedom. We understand all patients are different and respond differently and at Centre for Sight we pride ourselves in looking after our patients well.

We advise ALL patients to be seen by ourselves or other surgeons well versed with EVO Visian ICL surgery annually. While the implant does not change the human eye does change, in particular the crystalline lens and it is best to be monitored regularly.

All surgical procedures carry risk however the benefits of EVO Visian ICL surgery far outweigh some of the alternatives. Implantable Contact Lens surgery performed by a well experienced and competent surgeon will reduce risks. Centre for Sight surgeons have implanted this lens since 2002 and make considerable efforts to ensure patients are suitable, the lens size and power are optimised for each eye and surgery is performed to an exemplary standard in the best possible environment.

Cataract formation is a potential risk if the implant were to damage the crystalline lens during the procedure.

Infection is a possibility in every operation but very rare in EVO Visian ICL surgery. At Centre for Sight we are pleased to state we have not had a proven infection following Implantable Contact Lens surgery.

This can occur from a ‘steroid response”. The pressure in some individuals can go up following surgery from the steroid eye drops that are provided. This is rare and patients are advised to call if they experience a headache or eye ache and/or visual disturbance.

High pressures can occur from pigment dispersion where early after the procedure the iris rubbing against the Implantable Contact Lens can release pigment. In theory this can cause raised eye pressure from a blockage of the draining system. Although pigment dispersion has been seen transiently in our patients, this has not to date led to high pressures requiring treatment.

ICL surgery is performed using strong anaesthetic eye drops and patients do not experience any discomfort. The patient receives sedation either orally or intravenously and this usually takes away any anxiety. After surgery there may be a slight foreign body sensation when blinking and this is from the edge of the micro-incision which quickly settles.

An under or overcorrection is rare and if this is present and affects vision then if suitable additional laser vision correction surgery can be performed once the eyesight has stabilised for a few months.

No. Visian ICL surgery is a refractive procedure (like PRK/LASIK) and is considered an elective lifestyle improvement, as opposed to medical necessity (like for instance cataract surgery). In some cases individual insurance plans may offer a partial benefit that can save you money on the cost of the procedure, and you are advised to check with your insurance company or employer prior to the procedure.

Vision recovers very quickly after ICL surgery and this is what makes the procedure so exciting. At ten to fifteen minutes after the procedure we check your vision and the cornea to make sure all is well. Although misty or foggy soon afterwards, this clears after a night’s sleep. Visual recovery in very few patients can take slightly longer than one day and sometimes takes up to ten days. Although everyone is a little different, the vast majority of our IntraLASIK patients achieve legal driving vision or better the very next day. Note that vision may fluctuate a little in the first couple of weeks. This is a normal phenomenon and you will find that this will stabilise and improve day by day.