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Intra-ocular Contact Lens (ICL)

A new  and novel solution to some refractive problems includes the intra-ocular contact lens. It is precisely what it says. A thin lens made of "soft" material is inserted between the iris and the normal lens. This can only be done if you have your natural lens inside your eye, and have not been operated for cataracts. It has not been approved yet (3/2004) in the United States. For people who are presbyopic and hyperopic, this may be the best choice for treatment. Also, for people who are too myopic for  LASIK, LASEK, or PRK this is the treatment of choice vs. clear lens extraction with lens implant.

The "soft lens" is inserted

between the normal lens and the iris

Potential complications are mainly:

Cataract formation

Retinal Detachment

Clouding of the cornea

Cataract Formation

There has been a 2.7% incidence of cataract formation reported with this technology, but if that occurs, a cataract extraction and lens implant may be done with the results defined in the table.  If no cataract forms the patient still achieves excellent results.

Retinal Detachment

The following are decision tables showing, in the first table, the risk of retinal detachment. In the second table the risk and success if an operable cataract should form and then the subsequent risk of retinal detachment with the likelihood of achieving final good visual acuity.

Table 1. In this table, the risks of retinal detachment occurring after the initial implantation of the ICL are shown Ref: Sanders, D, JCRS Vol. 29:July 2003,24-26. This  table shows a good final visual acuity of 96%. This table is for young myopic patients.

 

 

This table, also taken from  Sanders, D, JCRS Vol. 29:July 2003,24-26 shows the incidence of cataract after ICL implantation and then requiring cataract extraction. The incidence of retinal detachment requiring repair after the cataract extraction in this scenario is shown with the probabilities of  moderate to severe visual loss of 0.039%, or the likelihood of good final visual acuity of 99+%.

Clouding of the Cornea

There is <0.1% chance of clouding of the cornea requiring corneal transplant

 

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