Implantable Contact Lenses in San Jose
Also Serving Hayward, Castro Valley, Concord and the East Bay
What Is a “Phakic IOL?”
TThe word “phakos” is Greek for lens of the eye. “IOL” is an abbreviation which stands for “intraocular lens”. An IOL is a lens that is placed inside the eye. The term “phakic IOL” means an artificial lens that is placed permanently inside a patient’s eye to correct nearsightedness and astigmatism without removing the patient’s own natural lens or corneal tissue. It is also known as the “implantable contact lens” (ICL). The implantable contact lens is made of a proprietary material called Collamer. It consists of collagen and a similar material contact lenses are made out of. The material has built in UV protection and is biocompatible with the eye for long term vision correction.
Why Would One Contemplate Getting an ICL?
ICLs are designed for nearsighted patients who desire reduced dependence or (possibly) elimination of glasses or contact lenses. The ICL is also good for people that have astigmatism or who have been told they are not a candidate for other laser vision correction procedures.
Who Would Be a Good Candidate for This Procedure?
Patients who are nearsighted, with or without astigmatism, and/or those patients who have corneas which are abnormal with respect to being too thin, too flat, or irregularly shaped, would be good candidates, provided that the anatomy of their eye can safely accommodate the lens.
The only way to know if you are a candidate for the ICL is to come in for a consultation with Dr. Mandel. We will do a complete analysis of your eyes to determine which vision correction procedure is best for you and your vision.
What Are the Alternatives to the ICL?
The alternatives to correct high amounts of nearsightedness and astigmatism include:
- Glasses, which are the time tested, tried-and-true method with the highest degree of safety.
- Contact lenses are also safer than any form of surgery, although there is a small risk of developing a sight-threatening infection.
- Corneal surgery such as LASIK, PRK, LASEK and EPI-LASIK. However, in patients with high degrees of nearsightedness and astigmatism in combination with a thin or flat cornea, it may be impossible to safely achieve full correction of the nearsightedness and/or the astigmatism with corneal surgery. Additionally, the quality of vision with respect to visual acuity as well as contrast acuity may not be as good in the higher degrees of nearsightedness with LASIK, PRK, LASEK or EPI-LASIK as it is with the ICL procedure.
What Can I Expect Before Surgery?
Two very small openings must be placed in the iris (colored part of the eye) using the YAG laser. Each opening measures about 0.5mm in diameter and ensures that the pressure between the chamber behind the iris and the chamber in front of the iris is equalized once the lens is implanted. These small openings are generally placed about two weeks prior to implantation of the phakic IOL. The procedure to create the small openings is performed at our Hayward facility and is very quick.
What Can I Expect During Surgery?
The procedure for the ICL is performed in our Federally certified ambulatory surgery center in Hayward. This ensures that the highest quality surgery is performed in the safest and most controlled setting using our dedicated surgical team. The surgery itself is quick. Typically the patient is back in the room for half an hour, but the procedure itself take between 5 to 10 minutes. It is virtually painless and the patient is awake, but relaxed.
After anesthetizing the eye with powerful numbing drops, a small incision is made where the white meets the colored portion of the eye. Additional tiny incisions are made to secure the lens safely into position. The lens is then placed through the opening and positioned in the eye. The patient is then observed post-operatively at the center to ensure that the lens is in proper position and that the pressure in the eye is not elevated. Most patients experience an immediate improvement in vision that will continue to improve over the next 24 to 48 hours.
What results can I expect?
The data submitted to the FDA for the STAAR Visian lens was based on the results of a multi-center U.S. clinical trial which included 526 eyes followed for up to three years. The data showed that 52% of all eyes were 20/20 or better, 68% of all eyes achieved 20/25 or better vision, and 89% achieved 20/40 or better vision without the use of glasses or contact lenses following the implantation of these lenses. The patient satisfaction rate based on a survey on each patient demonstrated a satisfaction rate of 99.4% at three years post-operatively. The data indicated that 95% of patients with good pre-operative vision and targeted for “zero” post-operative correction had vision without glasses or contact lenses of 20/40 or better after receiving the phakic IOL. Fifty seven percent (57%) had visual acuities without glasses or contact lenses equal to or better than their vision with the best possible glasses or contact lenses pre-operatively. In the STAAR Visian Toric lens Clinical Trial, in eyes with pre-operative best-corrected vision of 20/20 or better, 25.2% of eyes obtained 20/12.5 or better,, 89.3% of eyes obtained 20/20 or better,and 100% of eyes obtained 20/40 or better without the need for glasses or contacts. The results are even better when a touch-up with a LASIK can be performed!!
What if my best possible vision before surgery is not 20/20?
The FDA studies showed that a small percentage of patients actually enjoyed better vision without glasses than they had with glasses before the procedure. However, one must understand that for most patients the best one can expect is vision without glasses to be the same as the vision with glasses before the procedure. For example, if your glasses vision is 20/50 before the phakic IOL, then the best you can hope for is 20/50 vision without glasses after the ICL.
What happens if I do not achieve full correction of my nearsightedness and astigmatism from the ICL?
Although the lens powers are accurate, they are not perfect. Additionally, each individual and each eye heals differently. Accordingly, patients may experience residual nearsightedness, astigmatism, induced astigmatism, or induced farsightedness. Once the eye measurements are stable, which takes a few months following ICL surgery, additional surgery may be required in order to “fine tune” the vision. The additional surgery is not mandatory and “fine tuning” may be achieved with a thin pair of glasses or contact lenses. Depending upon the health of the patient’s cornea, residual myopia, induced farsightedness and/or astigmatism can be treated using LASIK, PRK, LASEK or EPI-LASIK. For patients whose corneas are irregular and abnormal, additional corneal surgery may not be possible and further correction with prescription glasses or contact lenses may be necessary.
Does the lens ever need to be removed or replaced?
The lens is designed to last and to stay in position forever. However, in some cases, if the lens is not in the proper position it may be necessary to reposition it. Most people get a cataract in their lifetime and the ICL will be removed at the same time the cataract is removed and replaced with another IOL where the natural lens use to be.
Are there potential risks with this type of surgery?
Of course all surgery has potential risks and complications. Although most complications are minor, some can be serious such as the development of a cataract which may require additional surgery. Some complications may even be sight-threatening such as bleeding, infection or retinal detachment. The FDA study of the Visian ICL over at least a three year period demonstrated an extremely low complication rate. If it were an unsafe or dangerous procedure, the FDA would not have approved the ICL!
What is the cost of the procedure?
The exact cost of the procedure depends on a number of factors referable to your eye and your specific needs. The factors which go into determining the cost of the procedure include the use of our Federally certified, State licensed surgery center, the surgeon fee, the cost of the lens implant, all supplies, follow-up for a one-year period, and all post-operative medical and optometric care. If additional laser surgery is required, an additional charge will be necessary. Because of the significant expenses associated with performing this type of surgery, including the number of staff and the surgical setting required, the cost to the patient is more than corneal refractive procedures such as LASIK, PRK, LASEK and EPI-LASIK.
A Summary Note from Dr. Mandel
You are considering vision correction because you want to get out of glasses and contact lenses, the ICL a safe and effective choice. Alternatively, you have a been told you are not a good candidate for laser vision correction, but because of the condition of your cornea, the above information serves to answer some basic questions regarding the ICL. It is designed to educate you so that you may formulate further questions for me and my staff, and to help you make a decision about undergoing surgery.
As you are aware, your eye is not perfect now and we cannot make the eye perfect. The purpose of the ICL is to help improve your vision such that you are able to wear much thinner glasses or more easily tolerate low-power contact lenses, or (hopefully) enjoy excellent vision without the use of glasses or contact lenses.
No surgeon can guarantee that you will have the result that you desire and/or that you will not incur complications from surgery. What I can guarantee is that I will perform the best possible surgery based on my years of experience as a cataract, cornea, and refractive surgeon. I will inform you of the pros and cons of the procedure, as well as the realistic expectations in your case, and fully delineate in writing the potential risks and complications of the procedure. Fortunately, although complications can and do occur, the FDA studies of the STAAR Surgical Visian and Visian Toric lenses, as well as my own personal results, have shown them both to be very effective and to have a very good safety profile — otherwise the FDA would not have approved the lenses.
Schedule Your Consultation Today
Dr. Mark R. Mandel is an experienced surgeon who has treated many patients suffering from extreme nearsightedness. During a comprehensive consultation at one of OPTIMA’s state-of-the-art office locations, he can evaluate your candidacy for the IOL procedure. Contact him today at 877-210-2020 ext. 3 to schedule your appointment today. OPTIMA is has four convenient office locations in Hayward, San Jose, Castro Valley, and Concord, CA.