ICL Surgery
Introduction to ICL Surgery
The implantable collamer lens (ICL) is a type of phakic intraocular lens (phakic IOL) used for vision correction, and it's the only TGA-approved phakic IOL available in Australia. ICL surgery is an advanced refractive procedure where a biocompatible lens is implanted into the eye, preserving both the natural lens and cornea. One such lens is the Visian ICL, available since the mid-1990s, with extensive long-term safety data supporting its use. ICL surgery offers patients a safe, reversible option for correcting myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism without altering the cornea.
Dr. Alison Chiu is the first surgeon across Australia and New Zealand to implant the ICL Viva, a groundbreaking lens that corrects presbyopia, offering a solution for aging eyes. Presbyopia is the term used when people develop issues with near vision, usually when aged in their 40s, and the ICL Viva can surgically correct presbyopia, in a way that is reversible, and has no impact on the potential outcome of future cataract surgery, which some presbyopic laser vision correction procedures can cause.
What is ICL Surgery?
ICL surgery involves implanting a lens just in front of your natural lens and behind the iris (the coloured part of your eye). The lens is invisible and cannot be felt, nor can it be seen with the naked eye. It can be seen by an experienced eye care provider during examination under a microscope. The ICL enhances your vision while preserving the eye’s natural crystalline lens, which remains essential for adjusting near focus. This feature is critical for tasks like reading and close-up work.
ICL surgery doesn’t require reshaping the cornea, as laser vision correction surgeries (like LASIK surgery) do. This means patients often experience "high-definition" vision without the risk of corneal weakening, a potential complication from procedures like LASIK or PRK. Additionally, ICL surgery does not exacerbate dry eye symptoms, a common side effect of laser vision correction. Dr. Chiu's patient-centered approach ensures that you receive the safest procedure tailored to your unique needs.
Permanent and Reversible Vision Correction
ICL lenses are designed to last a lifetime, providing permanent vision correction. However, the procedure is also reversible. Should your prescription change or your visual needs evolve, the lens can be safely removed or replaced with another ICL. Most older patients require cataract surgery and having an ICL procedure gives you more options with your vision correction at that time, compared to patients who have had laser vision correction.
Who is a Good Candidate for ICL Surgery?
ICL surgery is ideal for individuals between 21 and 45 years old, although the new multifocal ICL - the ICL Viva (TGA approved) extends suitability up to 60 years of age. Candidates should have a stable prescription. The procedure is particularly beneficial for patients with higher degrees of myopia, hyperopia, or astigmatism, and for those who may not qualify for laser vision correction due to thin or dry corneas.
If you wear contact lenses, you should stop wearing them a week before your ICL assessment.
ICL surgery is not recommended for individuals with glaucoma or cataracts. For patients over 60 or those with cataracts, cataract surgery may be more appropriate, involving the replacement of the natural lens with an intraocular lens implant.
Benefits of ICL Surgery
ICL surgery is an excellent choice for patients with prescriptions over -3.00, and can be performed in patients with a lower script if there are corneal issues such as weakness, or dry eye issues. ICL surgery is highly recommended for those with prescriptions of -5.00 or higher. In some regions of the world, laser vision correction over -4.00 is no longer recommended. Unlike LASIK surgery, which involves reshaping the cornea, ICL surgery preserves the cornea’s structure, minimizing the risk of biomechanical complications like ectasia. For patients with pre-existing dry eye, ICL surgery avoids worsening their condition, a common concern with laser vision correction surgeries.
Patients who have already undergone cataract surgery can benefit from ICLs as a secondary sulcus supplementary lens to further improve vision. Dr. Chiu and her team will thoroughly assess your suitability for ICL surgery based on your individual needs and visual goals.
Preoperative Preparation for ICL Surgery
If you wear contact lenses, please refrain from wearing them for 48 hours before surgery. In some cases, Dr. Chiu may recommend an iridotomy—a small procedure to control eye pressure post-lens implantation, particularly for patients with hyperopia.
ICL surgery is a day procedure, with both eyes typically treated on the same day. Anaesthetic eye drops are used to numb your eyes, and the entire procedure lasts 15 to 30 minutes. Vision improves quickly, with most patients noticing clearer vision the next day, and final vision stability achieved within one month.
Postoperative Care and Recovery
After the procedure, you will have follow-up visits at one day, one week, and one month post-surgery. While vision may be blurry immediately after surgery, most patients experience rapid visual recovery. Blurred vision usually clears by the following day, with full stabilization occurring within one month.
Risks and Complications
As with any surgery, ICL implantation carries some risks, including infection, lens damage, or pressure increases that could mimic glaucoma. Halos and glare may occur in the initial recovery phase but generally resolve quickly. Some patients may experience mild discomfort, such as grittiness, during the first few weeks after surgery.
However, serious complications are rare, and ICL surgery remains one of the safest and most effective options for vision correction, particularly for those seeking an alternative to LASIK surgery.
To learn more about ICL surgery or Dr. Alison Chiu's experience as the first surgeon to implant the ICL Viva in Australia and New Zealand, visit our blog.
