Myopia and hyperopia with / without astigmatism can be corrected by implanting an intraocular lens called Visian (ICL -- Implantable Collamer Lens) which reduces the refractive error.
What is Visian ICL?
The Visian lens is made of a soft, biocompatible material with a structure similar to natural collagen, called collamer.
Unlike artificial lenses for cataract, which require the removal of the opaque natural lens, the Visian ICL implant forms an optical assembly with the natural lens to correct diopters and help you see well without glasses.
The ICL lens is positioned by the surgeon inside the eye through a small incision that does not require sutures and is positioned behind the iris (the colored part of the eye) and in front of the natural lens. Because it is placed between the natural lens and the iris, the Visian ICL implant is practically invisible to the uninformed observer.
It focuses the light rays on the retina in a clear image, so that, after the surgery, you are able to become spectacle independent in the majority of situations, depending on your age and on the particularities of your eyes.
Advantages of Visian ICL
- The stability of the material is proven by over 25 years of experience and over 1.2 million Visian ICL operations performed worldwide to date
- The Visian ICL implant works in harmony with the natural lens, which allows the correction of refractive errors. In young people, the Visian ICL implant maintains the accommodation function, without the need for an additional correction for close vision
- The Visian ICL implant is completely reversible, which allows a reintervention.
When is it recommended?
Usually, we recommend the Visian intraocular lens implant when LASER surgical techniques cannot be applied, a fact established only after a detailed ophthalmological consultation and a set of special investigations.
This operation can be indicated:
- if you are 21-45 years old;
- if you have stable refraction in the last 6 months;
- if you have certain anatomical features of the eye that must be evaluated before surgery by the ophthalmologist through a series of detailed investigations.
How many diopters can be corrected?
- myopia up to -18 diopters (with or without astigmatism);
- hyperopia up to +10 diopters (with or without astigmatism);
- astigmatism up to 6 diopters.
Who cannot have the surgery?
You are not suitable for this surgery if you are in one of the following situations:
- your refraction has changed in the last 6 months;
- you have Fuchs corneal dystrophy, cataracts, uveitis, recurrent inflammatory diseases or narrow angle with or without glaucoma;
- if your eyes have zonular anomalies, lens subluxation;
- you have unacceptable values at the endothelial cell count (below 2000 / mm2);
- you have only one functional eye
- you have any other ocular pathology that could endanger your visual acuity
- you are pregnant or breastfeeding.
What investigations are recommended before surgery and where are they performed ?
Preoperatively, various measurements will be made: autorefractometry, keratometry, corneal topography, Pentacam tomography, pachymetry, visual field examination, optic nerve tomography, retinal tomography.
Preoperative consultation and investigations are performed at the Ama Optimex clinic in Str. Toamnei no. 54.
What should I do before Visian lens implantation?
If you wear contact lenses, you should stop wearing them for at least 21 days before consult, investigations and surgery. On the day of the surgery, you can eat a light meal, it is recommended to drink fluids and come to the operating room with a companion. Here you will be prepared by the specialized staff of our clinic, your eyes will be disinfected, anesthetic drops and drops that dilate the pupil will be instilled. It is very important to report any type of allergy you suffer from (food, medicine, etc.).
How is the surgery performed?
The procedure is done without hospitalization, with local anesthesia using drops, on different eyes on different days and lasts about 10 minutes. It is performed using the operating microscope:
- in the first step, the surgeon makes an incision of approximately 3 mm at the edge of the cornea (this has the property of self-sealing, does not require suturing);
- after the incision, the surgeon inserts a viscoelastic substance inside the eye with protective role;
- then, with the help of tweezers, the surgeon inserts the ICL inside the eye and positions it correctly;
- after inserting the lens, the protective substance is washed out and the intraocular pressure is restored;
- the eye will be bandaged until the next day at the postoperative follow-up.
In case of hyperopia correction, with / without astigmatism, the ophthalmologist will perform a laser treatment before the surgery, which involves creating holes in the colored part of the eye to facilitate the circulation of fluid inside the eye after implanting the ICL. This procedure is done in the consultation room, with local anesthesia using drops, it is painless and requires treatment with drops and tablets for several days, at home.
How is it after the surgery?
In the first days after the surgery, as the eye heals, the vision will be blurred, drops will be administered to dilate the pupil according to the prescription received from the operating room. Also, foreign body sensation, tearing and discomfort when exposed to strong light may occur, which are all normal and disappear under treatment.
What should I do after the surgery?
If you feel comfortable, you can watch TV, work on the computer and read immediately after removing the bandage. Otherwise, you will resume these activities as you feel comfortable, including driving or outdoor activities (using sunglasses for protection). There are also some temporary restrictions:
- it is forbidden to expose to dust, wind, for 30-50 days;
- it is forbidden to swim in the pool, lake, sea, for 30-50 days;
- in the first 2 weeks after the surgery, it is recommended to have help when washing your hair, so that water does not enter the eyes;
- it is forbidden to apply make-up the area of the eyes for 4 weeks;
- rubbing the eyes is forbidden (should be avoided for 3-4 months);
- local trauma and intense physical effort are forbidden especially during the first 6 weeks after surgery.
After surgery, if your eyesight decreases, if your eyes turn red or you experience pain, you should contact your surgeon or one of our nurses immediately.
Access the postoperative instructions here.
How will I see after the surgery?
The role of the procedure is to correct the refractive error, not to improve vision.By this, we mean that afterwards you will be able to see without glasses or contact lenses as well as you saw before the surgery with the best optical correction (glasses / contact lenses).
How long does postoperative treatment lasts?
After the surgery, you will receive a treatment scheme with drops and tablets that you must administer at home and which are of great importance for the correct healing and restoration of visual acuity. Treatment with antibiotic and anti-inflammatory tablets is carried out for a few days after the procedure, while the drops will have to be administered for a few weeks postoperatively. The ophthalmologist may modify or replace some drugs depending on the evolution, observed at the postoperative follow-ups
What complications can occur?
Complications that may occur with Visian ICL surgery are very rare and can be resolved with treatment:
- inflammation and / or intraocular infections (endophthalmitis);
- displacement of the lens;
- residual refractive error;
- decreased sensitivity to contrast;
- sensitivity to strong light;
- cystoid macular edema;
- retinal detachment;
- redness, tearing, foreign body sensation;
- damage to the inner layer of the cornea resulting in loss of its transparency, the patient may require corneal transplantation;
- opacification of the lens and cataract formation;
- increase in intraocular pressure with irreversible damage to the optic nerve;
- defective healing with areas in which the iris is adherent to the cornea.
When do I have to check in again?
After the surgery you must come to periodic, mandatory examinations, as follows:
- The next day;
- at one week;
- at 6 weeks.
Then, depending on the evolution, the ophthalmologist will recommend controls at 6 months and / or 1 year after the surgery.
How stable are the diopters after ICL surgery?
Because the human eye is made up of different structures that can change over time, there is a risk of refraction changing after a while. The Visian ICL is thus a reversible procedure, which means that the lens can be removed and / or replaced as needed.
Is the intervention reversible?
In very rare situations, after Visian ICL surgery, residual diopters may appear, which may require replacing the lens with another. The probability of needing such a reintervention is extremely low because preoperative measurements are currently made using state-of-the-art and high-precision equipment.
ICL and cataract / RLE
In case of cataract, the Visian lens will be removed from inside the eye, then the surgeon will perform cataract surgery with the facomemulsification of the natural lens that has become opaque and the implantation of an artificial lens.