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Higher refractive errors may benefit from ICL implantation, surgeon says
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THOROFARE, N.J. — Correcting refractive errors by using an implantable contact lens instead of corneal surgery appears to be an effective and safe procedure, according to Howard Gimbel, MD, MPH, FRCSC, who has implanted more than 160 of the lenses throughout the past 4 years. The lens is approved for use in Canada, where Dr. Gimbel practices, and is in trials in the United States for patients with refractive errors from 3 to 20 D.
"The speedy recovery time, the time patients have to wait for good vision — with no symptoms — is even more spectacular than with LASIK," Dr. Gimbel said.
The Implantable Contact Lens (STAAR Surgical) is inserted through a clear corneal incision and positioned in front of the natural lens in the posterior chamber. Most patients see 20/40 or better 1 day postoperatively, Dr. Gimbel said. Other advantages over LASIK include a quicker recovery time, no flap complications, no dry eye complications and reduced night vision problems because of the optical zone of the lens, he added. The ICL's optical zone is 7 mm, so side effects seen in some LASIK patients such as glare and halo problems are avoided.
Should the patient need a higher lens power, the original lens may be explanted, Dr. Gimbel said.
Dr. Gimbel said there may be a risk of glaucoma with the ICL, however. He noted a "temporary intraocular pressure problem" immediately following surgery in some cases. He also noted that risk seems to be low.
"There are some potential risks that have been established, but we don't know what will happen long term in relation to glaucoma, say in 10 or 20 years," Dr. Gimbel said.
Dr. Gimbel highly recommends the procedure for patients with high levels of hyperopia or myopia. "It's the only refractive procedure that I would consider for extremely high myopes," he said. People with moderate refractive errors but thin corneas or large pupils, who might not be LASIK candidates, might be able to benefit from an ICL procedure, he added.
More on the ICL is published in the Feb. 1 print edition of Ocular Surgery News.