Speaker 1:
Unless you get a haircut or you don’t goo
Dr. King:
Yeah. Well, today I need a haircut and I’m goo’ed . Otherwise I would look like bedhead.
Dr. Cha:
So you’re the refractive expert here. Um, so yeah. Oh,
Dr. King:
Okay.
Dr. Cha: ,
Dr. King:
Have you seen me?
Speaker 1:
Yeah. You know how to go with the flow.
Dr. King:
ICL stands for intra
Dr. Cha:
Implantable collamer lens.
Dr. King:
I’ve always heard intracameral lens. So there we go. That’s why. I mean, we’ve called it a couple different things, that’s why I’m asking. Yeah.
Dr. Cha:
And look, implantable collamer lens are a type of posterior chamber phakic, intraocular lens . So ICL .
Dr. King:
Hi, and welcome to Days of Our Eyes. I’m Dr. King.
Dr. Cha:
And I’m Dr. Cha.
Dr. King:
And today we’re gonna be going over other refractive surgeries that involve inside the eye versus on the surface of the eye. So we’re gonna be covering something called implantable collamer lenses. So stay tuned.
Dr. Cha:
Uh, implantable collamer collamer lenses are, it’s almost in the name implantable lens that we put into your eye. Mm-hmm. . Uh, and we do that to correct the vision. So instead of glasses or contacts are on the outside, or unlike, you know, LASIK, PRK and SMILE, where we change the, you know, front tissue of the eye, the cornea. We actually now add the ICL inside the eye, right behind the color part of your eye. But in front of the clear crystalline lens that you have, that you used to focus for different ranges of vision.
Dr. King:
Dang. Yeah. Is there enough room to do that?
Dr. Cha:
Just enough. .
Dr. King:
Unlike laser procedures, which are done in a laser suite, when we do an ICL, those are done in an operating room. They’re done in a surgery center. Mm-hmm. . So there’s more to the procedure. We’re putting something inside the eye. That means we do have to make an incision to go in through the cornea and dilate the pupil. That means the patient does get anesthesia. It’s a mild anesthesia. I call it the margarita. You don’t care. You’re relaxed. , you don’t feel anything. But that allows, uh, us to go in. We, the pupil’s dilated. It’s, it’s a lot like a cataract surgery in that respect, in that we’re gonna go in through the cornea ’cause it’s the fastest healing tissue in the body. And the surgeon places that lens in position, um, while the patient is lying flat on a surgery table. We’re doing this all under a surgical microscope. Ours is a three dimensional heads up microscope in our, in our suites. Um, so that everything is done 3-D and the lens is positioned once again, when you come out of the eye, when we make an incision through the cornea, that incision is self-sealing and, um, the procedure’s done.
Dr. King:
Yeah. It’s not, we try to keep it as simple as possible. The human eye doesn’t like to be messed with. Get in, do what you have to do and get out. When would we use an ICL? I mean, we have the ability to change the front of the eye mm-hmm. , but,
Dr. Cha:
Uh, for one, we don’t have to permanently change anything, right? Mm-hmm. , when we were having to manipulate or change the corneal anatomy for LASIK, PRK, SMILE, um, these are permanent changes. The great thing about ICL is that it doesn’t change anything permanently and it’s completely reversible if we have to. Mm-hmm. big advantage there.
Dr. King:
Yeah. Mm-hmm. plus, um, ICLs work with higher prescriptions. , there are limits to what a laser can correct. Plus there are limits to the amount of correction a cornea can take. There may be other, you know, health issues such as severe dry eye. Well, we know if we do laser procedures, we can actually potentially make dry eye worse. So if we do something like an ICL, we’re putting something in the eye. We’re not permanently changing the tissue. We have much higher power ranges we can reach. So, you know, the person who’s -9, -10, -12 have been told they can’t have LASIK. But you can potentially have an ICL put in.
Dr. Cha:
One big difference though is that at least per, um, currently, I believe you correct me if I’m wrong, uh, ICL only corrects nearsighted prescriptions, correct? Yeah. Myopic prescriptions.
Dr. King:
Correct. It is only for nearsighted folks. Farsighted folks. Sorry. we’re putting it in the space between the iris and the physiological lens, the crystalline lens inside the eye so it’s not visible from the front. Mm-hmm. , that’s a really small space. So the advantage to a nearsighted lens, it’s a concave lens. It’s thinner in the middle and thicker at the edges. Well guess what? That lens, the crystalline lens bows out so it kind of fits better. Mm-hmm. a far-sighted person, their lens is thick in the middle. Well, we can’t put a thick in the middle lens in front of a lens inside the eye that’s thick in the middle. They’re gonna bump each other. Mm-hmm. they can’t touch. And we now have the capability to measure all that stuff and make sure they won’t touch. Mm-hmm. and in our practice, we are currently using one called the EVO ICL.
Mm-hmm. , because it has fenestrations. One of the things that happens is fluid is made in the back of the eye, flows through the pupil into the front of the eye to drain out. That’s what creates pressure in the eye and that kind of stuff. We don’t wanna obstruct that flow with some kinds of ICLs. We’re putting a lens right between the, in across the pupil, between that iris and that lens. What if we block the flow? The old way to get around that was we would do a laser peripheral atomy, we would actually laser a hole in the iris. So fluid can flow around the edges of the iris. With the newer designs, there are actually fenestrations or holes in these lenses in a few places that allow the fluid to flow more freely, thus reducing the risk of increased pressure or fluid buildup in the eye.
Dr. Cha:
ICLs in the past, um, just the pre-workup and, you know, getting that laser peripheral aeronomy, the LPI, uh, has its own recovery process. Correct. But with the EVO ICL, with the fenestration, the hole in the middle, um,
Dr. King:
And on the sides and on sides, there’s three
Dr. Cha:
mm-hmm. patients don’t have to go through, um, that recovery process. They could just get, you know, worked up. You know, we get the calculations to pick the right lens, and then you go right in to get you seeing better
Dr. King:
It has improved the safety and streamlined the process. Mm-hmm. and that is something that everybody’s looking for these days. Safety and convenience. Mm-hmm. . So who’s a good candidate for ICLs? First of all, as with any refractive procedure, we need you to have a stable prescription. If your vision’s changing, you’re not a good candidate for surgery, period. And I don’t think we’ve stressed that enough. So we want a stable prescription one year to the next. Second of all, um, what ages? It’s got a pretty broad range. You know, we start around age 20, goes up through the mid-forties. What kind of prescriptions are good for it?
Dr. Cha:
With EVO ICL we can correct for, you know, moderate to high amounts of nearsightedness, myopia, and also astigmatism as well.
Dr. King:
Um, it starts around a -4 mm-hmm. and then can go up pretty darn high. Yeah.
Dr. Cha:
Maybe you don’t qualify for LASIK because you might have, your corneas just might not be stable or, um, too thin. Too thin, you know, and that’s why it’s always important to get, you know, full health evaluation. Especially, uh, specifically looking at the cornea to see, especially if you’re interested in some kind of, uh, refractive corrective surgery.
Dr. King:
What’s the recovery like? Mm-hmm. ?
Dr. Cha:
Well, I mean, for LASIK, you know, we have you on drops for about a week, or let’s say seven days for a week. Uh, and mainly it’s just to ensure that the flap heals properly, that, you know, we’re lubricating. Well, uh, ICL is different because we’re going inside the eye. And like Dr. King was saying, the eye doesn’t like to be messed with, doesn’t like to be poked around. So there’s a different kind of inflammation that we’re watching, uh, more inside the eye. Our ICL patients, I believe they’re heal healing time and they’re on drops for only seven days as well.
Dr. King:
You notice a difference in your vision the day of surgery. Mm-hmm. . Uh, so you do get some immediate wow factor. Um, but it’s gonna sharpen from there. We’re gonna bust a myth. Y’all .
Speaker 1:
So a lot of people ask, after I have ICL surgery, will people be able to see the lens from the outside looking in?
Dr. King:
So, can you see the lens after it’s in the eye… No. Back in the day when people had cataract surgery and we put lens in their eyes, lenses in their eyes, um, they, they were shiny. Mm-hmm. , you got this like glistening effect. Newer lenses have non-glare coatings on ’em, just like your glasses lenses do. So they’re not as shiny and reflective. Mm-hmm. And, and, and the ICL is behind the iris mm-hmm. . So it’s back there. It has a non-glare on it. Mm-hmm. So, no, you’re not gonna see the lens when somebody’s, when if somebody’s looking at you, they’re not gonna see the lens.
Dr. Cha:
Well, uh, thanks for joining us today on days of Our Eyes, where we talked about ICL implantable collamer lens. So don’t forget to subscribe to our channel. Give us a, like, uh, leave a comment, ask a question, interact with us. Um, but until next time, the name’s Dr. Cha
