In the past three decades, LASIK laser eye surgery has grown to become the most popular refractive surgery and most popular elective surgery worldwide, with more than 10,000,000 procedures performed. LASIK can improve visual “acuity”, the acuteness or “sharpness” of vision, with nearly all patients enjoying at least 20/40 acuity after surgery and many enjoying 20/20 vision or better.
However, don’t take LASIK for granted and think that it’s always successful. LASIK and its relatives (PRK, LASEK, Epi-LASIK) are safe, fast and easy ONLY IF you are a suitable candidate for them and ONLY IF you put your eyes in the hands of a competent, well-trained refractive surgeon with the right technology.
If you are nearsighted (myopic), implantable contact lenses (ICLs) may make it possible for you to get better visual acuity AND quality. This procedure could help you avoid the risk of getting poor results from traditional LASIK surgery and potentially ruin your vision forever.
Vision Acuity
First, what does visual acuity mean? If your visual acuity is 20/20, you can see at a distance of 20 feet what the average person with normal vision sees at 20 feet. If your acuity is 20/40, you can see at 20 feet what someone with 20/20 vision can see at a distance of 40 feet. And, if you’re really lucky and have something like 20/15 acuity, you can see at 20 feet what other people must move closer (to 15 feet) to see.
In general, people with visual acuity problems are nearsighted, farsighted, and/or have astigmatism. The goal of LASIK and other laser vision correction procedures is to correct these acuity problems so that you don’t have to rely on glasses or contact lenses. However, there is more to good vision than 20/20 acuity. It is possible to have great visual acuity but poor visual quality. The reverse is also true.
Vision Quality
Visual “quality” refers to vision problems that are most common in low-light situations or at night, such as diplopia (double vision), glare, halos, blurriness, starburst patterns, ghosts or loss of contrast sensitivity. The ability of the eye to distinguish contrast (tell the difference between different shades of white and grey) is a very important factor because many of the things we do routinely, such as recognize people’s faces, rely on our sensitivity to contrast. These problems are called “higher-order aberrations” and they cannot be corrected by traditional LASIK procedures.
These “quality” problems are also very common risks and complications of LASIK surgery. Many patients who undergo LASIK surgery in the hands of under-qualified LASIK surgeons are left with serious declines in the quality of their vision because they had higher-order aberrations that were not properly diagnosed. Just when they thought their vision would improve after LASIK, the opposite occurred.
What’s an Implantable Contact Lens?
Implantable contact lenses, also known as phakic intraocular lenses, are an alternative to traditional LASIK surgery for nearsighted patients and, in many cases, may provide them with better vision than LASIK ever would. “Phakic” refers to an eye that still has its natural lens, compared with cataract surgery where the natural lens is removed and replaced. One of the best parts about implantable contact lenses is that they are permanent and work just like conventional contact lenses without the hassle.
Implantable lenses resemble contact lenses and are either inserted and attached to the iris (the colored part of your eye) or inserted in the chamber between the iris and the cornea (the clear lens that covers the iris). This will depend on which type of lens your surgeon chooses. These intraocular lenses (IOLs) are similar to those used in cataract surgery. However, in cataract surgery the cloudy natural lens is replaced by the IOL; in the ICL procedure, your natural lens remains in place.
Types of Implantable Contact Lenses
There are two trade names for implantable lenses approved by the FDA: one of them is called Verisyse and the other is called Visian ICL. Here is some information about the differences:
- The Verisyse phakic IOL is made of a type of rigid plastic called PMMA, similar to cataract IOLs. It is designed to correct moderate levels of myopia. It is inserted through a sizeable incision and attached to the iris. The procedure takes about 15 to 30 minutes and the incision is closed with tiny dissolvable sutures. You will not be able to feel the Verisyse IOL in your eye, but you and others may be able to see it if you look closely.
- The Visian ICL implantable lens is made of Collamer, a unique material made partly from collagen, a protein found naturally in the body. Collamer also protects your eyes from harmful UV exposure from the sun, which can prevent degenerative conditions like cataracts. The Visian ICL is designed to correct moderate to severe levels of myopia. It is foldable, which means it can be inserted between the iris and your natural lens through a very tiny incision. The procedure takes about 10 minutes and no sutures are necessary. You will not be able to feel the ICL in your eye and it is invisible to the naked eye.
Advantages of Phakic IOLs
Implantable contact lenses work with your eye’s natural crystalline lens to focus light accurately and correct your vision problems. You will also be free from glasses or conventional contact lenses. The Visian ICL Collamer lens, in particular, is said to have the ability to deliver high-definition images that are clear and crisp at any distance, and sharper than any other refractive procedure.
Unlike LASIK surgery, which makes permanent changes to your cornea with a laser to reshape its curvature and refocus the light to improve your vision, implantable contact lenses accomplish the same goal differently. The implanted lens bends the light rays to correct distance vision, and near vision improves on its own by a process called accommodation. All of this is done without making any permanent changes to your corneal tissue. And phakic IOLs can be replaced or removed, if necessary, to adapt to future changes in your eyesight. Changes made during LASIK surgery are not reversible.
Implantable contact lenses are ideal for people who are not suitable candidates for LASIK due to thin corneas or high degrees of myopia. Once the lenses are implanted, there is no maintenance required, unlike conventional contact lenses. And phakic IOLs have a proven track record for safety.
Summary
All surgical procedures carry risks, and implantable contact lenses are no exception. Only you and your eye surgeon can determine which type of vision correction surgery is best for your unique eyes. Both LASIK and phakic IOLs have phenomenal success rates when performed by the right surgeon with the right technology. Discuss the best course of action for you with your doctor.
Please visit us at 5th Avenue Eye Center if you’re eager to learn more about New York LASIK eye surgery or Visian ICL implantable contact lenses. With the right surgeon, you can change your life in 15 minutes!