What are Implantable Contact Lenses?
September 8, 2022
What are Implantable Contact Lenses?
Patient: “I’ve been told I’m not a candidate for LASIK!”
SharpeVision Doctor: “That may be true, but you may be an excellent candidate for the EVO ICL. With the EVO ICL we can correct up to -16 diopters of nearsightedness and up to 4 diopters of astigmatism.” (That’s a lot-in fact only 1 in about 6000 people are estimated to have that much nearsightedness).
Patient: “Wow!”
I’m very excited to discuss the advances in a fantastic technology called the EVO ICL (Implantable Contact Lens) to correct your nearsightedness and astigmatism-especially if you’ve been told you were not a candidate for LASIK or PRK vision correction surgery. And check out Joe Jonas and his journey getting the EVO ICL!
History of Implantable Contact Lenses
First, a little background. Implantable contact lenses have been in use for nearly 30 years. The first one approved in the United States was in 2005. In early 2022, the latest model called the EVO ICL was released. This made a dramatic improvement in the ease and safety for the patient. We no longer had to perform a laser procedure on the patient prior to implantation of the lens. The optic of the lens on the EVO ICL is slightly bigger, which theoretically improves the quality of night vision and reduces glare/halos in low light settings. The markings for astigmatism are a little easier for the surgeon to see to assure the perfect alignment for correction of astigmatism. All medical technology is in a constant state of evolution, which is partly why the latest model is called the EVO ICL.
At SharpeVision, we have been implanting the ICL since 2015. Prior to implanting the ICL in my patients, I visited other surgeons to see their techniques and ask lots of questions. Since then, I have implanted nearly 1000 ICL lenses. Shortly after the approval of the EVO ICL, I implanted them in my 25 year old son Max. Max, like myself, had a high degree of nearsightedness. I had LASIK in 1998 prior to the approval of the ICL lens in the United States. I figured since I gave my son highly nearsighted eyes, it was only fair for me to fix it for him! He now enjoys uncorrected 20/15 (better than 20/20) vision in each eye. See the story here: https://www.king5.com/
What is an Implantable Contact Lens?
An implantable contact lens is an easy concept. An implantable contact lens is made of a material that looks and feels similar to a contact lens that we would place on the surface of our eyes. However, an implantable contact lens is placed inside the eye behind the colored part of your eye. No one will ever see it. Even as a surgeon, it is very difficult to see the lens under a microscope, because the EVO ICL is virtually invisible. The EVO ICL remains in the eye indefinitely. It does not wear out; it does not need to be changed or replaced. Most people will develop a cataract in their 60s or 70s. When this happens the EVO ICL will be removed and the cataract material will be removed as well. Then a custom intraocular lens will be placed in the eye which does the same function of eliminating glasses but also removes the clouded natural lens. So for most people, the EVO ICL will last anywhere from 25 to 50 years depending on your age when the EVO ICL is implanted.
What is the Procedure Like? Is it Painful?
The ICL procedure takes about eight minutes per eye and is completely painless. You are awake but sedated with an oral medication, so you are very relaxed and feel very little. In fact, the procedure is a little bit easier in terms of comfort as compared to PRK or LASIK. The recovery is similarly a bit more comfortable with the EVO ICL. With LASIK surgery, our patients generally experience four hours of burning and irritation. With PRK surgery, that burning and irritation extends for about 48 hours. With the EVO ICL implantation, there is generally no discomfort at all postoperatively. There is more light sensitivity because we do dilate your pupils to implant the lens. This dilation usually wears off by the following morning and most of our patients see 20/20 on the vision chart. However, there is always some degree of fogginess during the recovery period, but most people can drive and go back to work the very next day after the EVO ICL implantation.
Are Implantable Contact Lenses Safe?
In any medical procedure there are risks and benefits. I believe the EVO ICL is safe enough to implant in my own son. There are risks wearing contact lenses as well: infection, intolerance, irritation of the surface of the eyes. There are also very nice benefits to living life seeing clearly without the burden of glasses sitting on one’s face or contact lenses sitting on one’s eyes. As a surgeon, I see the risks divided into short term and longer-term. The short term risks in the first 24 hours are an elevated intraocular pressure. Because I put some protective gel inside the eye to coat, protect, and maintain the space inside the eye, it can cause a short term intraocular pressure elevation. We rinse out this gel thoroughly at the end of the procedure, but perhaps one in 50 patients will have some intraocular pressure elevation. We watch for this very carefully and use medication to prevent this potential pressure elevation. Another risk is that the lens may be too big for the eye and may need to be removed soon after the lens implantation and replaced with the next smaller size. There is a less than 1% chance of this risk in my hands. The other risk is that the lens may be too small and you get astigmatism. This occurs if the lens rotates slightly which can blur your vision or create astigmatism. This can be corrected by replacing the lens with the next bigger size.
Longer-term risks are that a cataract can develop in your eye. As I described above, cataracts typically happen in our 60s or 70s, so it is something to be expected at some point later in life, but generally does not happen in 30 year olds or 40 year olds. We do know also that those who are more highly nearsighted have risk of cataract development at a younger age. In the FDA studies on the previous model lens, the risk of cataract development was about 1% over a seven-year period. With the EVO ICL, our European colleagues who have been placing these lenses in their patients eyes for about 10 years are indicating that they just are not seeing cataracts develop at all. This data is, of course, anecdotal but very encouraging that the newest model EVO ICL may be even less likely to cause cataract than the previous generation model.
The risk of infection with an implantable contact lens is never zero, but I believe the risk of infection is extraordinarily low. I have never had a patient have an infection after implanting the ICL, but in cataract surgery, the risk of infection is probably somewhere in the neighborhood of one in 10,000 eyes implanted with an intraocular lens. I would guess it’s even lower risk for the ICL, because our patients are younger, healthier, and the procedure is less involved. Since we are not removing your natural lens, the theoretically slightly greater risk of infection with cataract surgery lens removal is not a factor.
Another risk to consider is the risk of trauma to the eye. I believe the risk of trauma to the eye is unique in every case. If someone sustains an eye injury, it can be as simple as a corneal abrasion, which is painful but heals in the vast majority of people without further problems. But it could also be a ruptured eyeball that results in removal of the eye. Yes, this is extreme but unfortunately does happen in extreme eye trauma. I do not believe that the implantation of the EVO ICL creates any additional risk over what would happen otherwise if you sustain an eye injury. I always recommend using eye protection when working in any trades such as carpentry, masonry, plumbing, etc., because one never knows when something could hit you in the eyeball. Generally, the OSHA standards require eye protection in any such circumstance. I also recommend using eye protection at home for any hammering, chipping, outdoor work, etc. It’s also wise to use eye protection when playing sports such as tennis, racquetball, pickle ball, etc., because a small ball can cause some of the most devastating injuries to the eyeballs.
Is the EVO ICL Converted by Insurance?
Generally speaking, the EVO ICL fee is not covered by insurance. There are a very few exceptions to this general rule. Certain tech companies and others try to put together an excellent benefits package that sometimes covers part or all of the expense. However, the EVO ICL is a superb value. It incorporates the highest technology available in the world today and can allow our patients who have extreme myopia to see perfectly clearly without glasses. It is an amazing thing to behold. At SharpeVision, we do offer financing to help you to receive the procedure and make payments, so that you can benefit right away from this amazing technology.
Am I a Candidate for the EVO ICL?
The only way to know for sure if you are a candidate for vision correction surgery is to have a comprehensive completely free exam at SharpeVision Modern LASIK. You can schedule online at sharpe-vision.com or call us at 425-451-2020 (Seattle-Bellevue). We perform all the tests as described in my earlier post: What happens in a LASIK Consultation?
We very much look forward to seeing you in our clinic, so that we can get to know one another and determine how best to help you to live your life free of the burden of glasses or contact lenses.
At SharpeVision we are making glasses a thing of the past!
Dr. Matthew R. Sharpe
