It includes many measures to verify that the implant can be inserted without risk. In particular, the measurement of the space between the cornea and the lens and the endothelial cell count which will be monitored every 6 to 12 months imperatively.
The ICL is a soft implant that can be inserted through a small incision. It corrects the strong ametropia: myopia, hyperopia, alone or associated with astigmatism. ICLs have been installed since the early 90s with excellent optical results. They often improve the best corrected visual acuity in glasses.
All calculations of lens powers are done with specific software based on the data of each eye of each patient.
They are essentially anatomical:
- The endothelial density varies according to age but an endothelial cell density lower than 2000 cells is a contraindication to the phakic implant
- The depth of the anterior chamber should be greater than 2.8 mm for myopic patients and 3 mm for hyperopic patients
- Traumatic risk sports should be avoided in implanted patients, but strong myopia beyond 6 D is a contraindication for all combat sports
- Marine diving requires precautions, but it is difficult to establish a maximum depth
- In addition, it is also important not to press or rub your eyes
Contraindications according to age:
- The implant cannot be placed before the ametropia is stabilized except in the very particular case of amblyopia in the child
- It is best to avoid phakic implants after 50 years except in special cases
The phakic implants are for the strong ametropic ones. The range of ametropia that can be corrected is broad: myopia, hyperopia, but also astigmatism. The correction of presbyopia is under study.
The surgery is done under local anaesthesia by eye drops. The intervention lasts half an hour. It involves injecting the folded lens into the eye through a small incision. This one unfolds then and must be positioned between iris and crystalline lens.
Clinic attendance is approximately 1 hour.
- The immediate postoperative course is simple treatment with eye drops only. They are painless. Functional recovery is fast. The resumption of work is the day after the intervention. It is not possible to have a work stoppage for this surgery considered as comfort.
- In the long term, the endothelial density must imperatively be checked every 6 months. In the case of marked endothelial loss, the lens must be removed.
- The phakic implants give very good refractive results and often the best corrected visual acuity.
- The predictability is excellent; more than 95% of patients are more or less 1 D emmetropia hence an equivalent satisfaction rate
- The anatomical stability and refractivity is remarkable
- Safety is greater than 1: all patients retain their visual acuity or gain 1 line at 2 years
- Efficacy (Preoperative corrected visual acuity / visual acuity ratio without postoperative correction) is very close to 100%
The advantages are numerous:
- Precision and predictability of the refractive result
- Calculation of the easy and precise power with a wide range of correction
- Conservation and even gain of the visual acuity with a good quality of vision
- Reversibility (provided very regular monitoring to withdraw implants before any complications especially endothelial)
- Refractive stability, Quality of vision, Safety, Efficiency