The Visian ICL™ (Implantable Collamer® Lens; STAAR Surgical) has become a valuable addition to the to the refractive surgery options I offer my myopic patients, and I’ve implanted the posterior chamber phakic IOL bilaterally in hundreds of patients since its FDA approval 3 years ago. This extensive surgical experience has confirmed for me the ICL’s excellent refractive predictability and intraocular stability.
After experience with all three types of phakic IOLs, I feel that the posterior chamber style is superior to angle supported and iris-fixated styles. And, there is strong evidence that for moderate to high myopes, the ICL produces better quality of vision than later refractive surgery. In addition, ICL acuity degrades less as the pupil dilates, and the visual outcome does not become less predictable as the size of the refractive correction increases.
The Visian ICL is made from a single piece of STAAR’s Collamer® material. This material has demonstrated good biocompatibility and stability over the 15 years that it has been studied and used outside the US. The ICL can be implanted bilaterally on the same day through a standard cataract-style incision, which usually takes about 10 minutes per eye. The ICL is available in several sizes, based on dioptric power.
The Visian ICL is approved for use in myopic adults aged 21 to 45 years, however, I routinely use the ICL in patients older than 45. ICLs designed to correct hyperopia and astigmatism are not available in the US yet, but they are currently in use in other countries. Without a toric ICL available to me, I employ incisional techniques, such as limbal relaxing incisions, to correct astigmatism.
As my practice’s experience with the Visian ICL has increased, we have widened the range of patients we will consider for ICL implantation. I am comfortable implanting the ICL in moderate to high myopes 18 to 60 years old, lower myopes who require very precise vision, patients with thin corneas, patients with keratoconus or corneal topography indicating forme fruste keratoconus, and people with dry eye.
Complications with the Visian ICL are rare and manageable. However, despite all the benefits of the Visian ICL, I don’t automatically recommend it for every patient. I consider the ICL an excellent tool in my refractive surgery toolbox, along with LASIK and PRK. I choose the most appropriate option for each individual patient, whether that is an ICL or corneal refractive surgery.
Read the full article in
Have a question or comment on this article? Use the "Comment" link above to leave your thoughts, and the author will respond.