A new vision correction procedure called the Implantable Contact Lens (ICL) may soon help correct nearsightedness in individuals with thin, flat corneas and other conditions such as diabetes that have restricted them from experiencing traditional LASIK surgery in the past.
The Food and Drug Administration (FDA) panel has recommended the ICL for approval. Final FDA approval is now pending. One of the major benefits of the ICL is its reversibility. A major difference of ICL compared to LASIK is the fact it requires even greater surgical skill since the lens is being implanted inside the eye. In contrast, LASIK involves reshaping the outer part of the eye the cornea with a cool beam laser.
The ICL, produced by STAAR Surgical in Monrovia, CA, is made of a new generation of biocompatible IOL materials called Collamer. It is implanted in the posterior chamber (on top of the natural crystalline lens). Think of it as a contact lens inside the eye instead of on top of the cornea, thus eliminating the need for external correction and the annoying side effects of dealing with contacts.
As with LASIK surgery, the patient is awake during the procedure which lasts approximately 10 minutes per eye. The ICL is pending approval for individuals with refractive errors of between -3 and -20. It has not been approved for astigmatism at this time.
The wide range of refractive errors (-3 to -20) may also help individuals because higher refractive errors corrected with LASIK sometimes require enhancements given the significant amount of tissue that is altered.
Most important, the results of the clinical trials supervised by John A. Vukich, M.D., at the University of Wisconsin between November 1998 and July 2001 showed that the ICL was comparable to LASIK. Dr. Vukich compared results from two concurrent, consecutive series that were composed of 559 eyes undergoing LASIK and 210 eyes that received the ICL. Myopia in both groups ranged from -8 to -12. Ages of the study participants ranged from 21 to 45.
The results one year after surgery showed statistically significant differences favoring the ICL in improvements in best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), predictability and stability.
The one-year UCVA results revealed that more eyes with the ICL had UCVA of 20/20 or better 52% to 36% - compared with the LASIK-corrected eyes.
Additionally, with the ICL both intraoperative and postoperative complications were low and no late complications were reported.
My prediction is the ICL is the first in a future wave of implantable lens that will provide even more options in laser vision correction. For example, CNN reported recently on Alcons RESTOR lens another lens technology which helps corrects nearsightedness AND farsightedness and ends the need for reading glasses (presbyopia).
One of the challenges to existing LASIK is that it does not correct presbyopia for individuals 40 and older. Our best option as LASIK surgeons is a procedure called monovision in which we correct one eye for near, the other for distance. An implantable lens that corrects this condition and refractive errors such as nearsightedness and farsightedness will have major appeal with baby boomers.
I am the only Houston surgeon participating in the Alcon RESTOR clinical trials. The 23 patients who have received these lens have been treated successfully.
Hopefully, the FDA will approve this lens in the near future, too.
IF YOU WOULD LIKE YOUR QUESTIONS ANSWERED PERSONALLY
If you would like to learn more about the aforementioned or to email questions, visit our website at www.doctorwhitsett.com. Or better yet, call Michelle, our laser vision coordinator, at 713-365-9799 to set a time for your free consultation. During that consultation, I will meet personally with you and answer your concerns one-to-one.
Dr. Jeffrey C. Whitsett 
Jeffrey C. Whitsett, M.D., has twice been named a VISX Star surgeon, an honor bestowed on the top 100 providers of Laser Vision Correction in the United States. Presently, he serves as president of the Eye Laser Center of Houston. A 1986 graduate of the University of Oklahoma Medical School, he has been in private practice for more than a decade specializing in refractive and cataract surgery.
Dr. Whitsett is Board Certified by the American Board of Ophthalmology and the Texas State Board of Medical Examiners. He is involved in several major national and international ophthalmology organizations, and lectures nationally for Alcon Surgical about the most current concepts in cataract and refractive surgery.
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