This surgical procedure is meant primarily for the correction of a greater degree of short-sightedness and far-sightedness. It is used in cases where a laser surgical procedure would be ineffective or risky. Today, it is also possible, in some cases, to resolve the problem of presbyopia using a phakic multifocal lens.
This is an intraocular surgical procedure that we perform only in case whereby the patient fulfils relatively strict pre-surgery criteria (sufficient density and quality of endothelial cells in the cornea, suitable anatomical requirements, normal intraocular pressure).
As such, thorough eye examination is necessary, including measurements of the frontal chamber of the eye and examination of the corneal endothelium. Based on the results of these examinations, we decide if this type of surgery is suitable for the patient, and we select lenses according to the dioptre error.
ICL implantation using injector
ICL – in between the iris and the frontal surface of the lens
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Surgical procedure
During the procedure we place the implant (phakic lens) inside the eye, into the optical axis while at the same time keeping the natural lens (as opposed to the refractive extraction of the lens). Combining the implanted lens together with the natural lens we achieve the required correction of the dioptre error. At the same time, we maintain accommodation (focusing) of the natural human lens in case of myopia and hyper-myopia in younger individuals or we replace accommodation when resolving presbyopia.
The implantation of a phakic lens is more difficult compared to laser eye surgery because here we interfere with the inside of the eye. Modern implants are placed inside the eye using an opening of about 2–3 mm, this being about a third or a half of their true size. It is possible to temporarily roll up or fold these up during the implantation process into the eye due to the modern soft materials from which they are manufactured. The implanted lens is most commonly fixed onto the iris (the dominant colourful part of the eye) or it leans against it.
Probably the most often used phakic implant is a lens implanted behind the iris, once that copies the frontal surface of the natural lens. This type of lens is known as the intraocular contact (Implantable Contact Lens – ICL) and is the only method used in case of correcting presbyopia.
Today, this procedure is performed under local anaesthesia once the eye has been desensitised using eyedrops. The patient is required to rest after the surgery and to apply the prescribed eye drops. The surgery of the other eye is performed 2 days to two weeks after the first eye depending on the type of the implant used and the individual healing ability.
Reductions in work and personal life are recommended depending on the type of implant used and the activity in question.