ICL technology

Whether playing sports or watching a 3D film: glasses can be perceived as annoying or bothersome. And not all eyes are made for wearing contact lenses. However, people with severe refractive error or severe astigmatism are not necessarily suitable patients for laser eye correction. These patients may be considered for the insertion of an implantable lens (abbreviated to ICL, i.e. implantable contact lens).

The ICL makes clear vision possible in the long term without visual aids: the lens remains permanently in the eye and can be replaced or removed if necessary (e.g. if vision changes). The implantable contact lens is an excellent alternative for near-sighted people with a refractive error of more than minus two dioptres and far-sighted people with a refractive error of more than plus three dioptres – also in combination with astigmatism

ICL technique

The ICL is inserted between the iris and the natural lens inside the eye. In this way, the artificial lens – together with the natural lens – ensures that the light is properly focused on the retina again, enabling the patient to see clearly again – without any additional aids such as contact lenses or glasses. 

Who is it suitable for?

The implantable lens is an option for almost any refractive error. In principle, the implantation of an artificial lens is suitable for patients older than 21. The following dioptre guide values apply: 

Furthermore, a minimum anterior chamber depth is required for the implantation of an artificial lens. This is 2.7 mm for near-sightedness and 3.0 mm for far-sightedness.   

The exclusion criteria for laser eye correction using the ICL technique are: 

  • Age: Treatment before the age of 18 is not recommended due to the expected change in visual acuity. 
  • Pre-existing glaucoma with visual field defects: Due to the risk of increased intraocular pressure with certain forms of glaucoma, this type of treatment is also discouraged. 
  • For advanced corneal diseases 
  • In the case of keratoconus (corneal bulge)  

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Preliminary examination 

Before an eye operation using ICL technique, an individual consultation takes place, during which the treating ophthalmologist informs the patient about the ICL procedure as such, discusses possible risks and side effects, and answers the patient’s questions. 

In order to determine whether the patient is suitable for ICL implantation, a comprehensive preliminary examination (duration: approximately two hours) is also carried out. In order for the associated examinations to deliver correct, usable results, it is important that patients do not wear hard contact lenses for at least two weeks before the examination appointment or soft contact lenses for at least one week before the examination. This preliminary examination also involves administering pupil-dilating eye drops. 

This preliminary investigation will include:

  • Measurement of visual acuity
  • Measurement of the eye itself
  • Examination of the eye itself with a slit lamp and magnifying glass
  • Measurement of intraocular pressure
  • Corneal topography 
  • Determination of the anterior chamber depth

Treatment

On the day of the procedure itself, patients are given a sedative if they wish, which puts them into what is known as 'twilight sleep'. Drops are also added to the eyes, which numb the cornea. This means that patients do not experience any pain during the relatively short operation – an ICL implantation takes about ten minutes per eye.

It is important that no cosmetic products (such as perfume, face cream or make-up) are applied on the day of the operation itself. 

Schedule: 

  1. Anaesthesia of the eye using anaesthetic drops 
  2. Insertion of an eyelid retainer to prevent the eye being treated from blinking 
  3. Opening of the cornea at the edge (small incision)  
  4. Insertion of the artificial lens inside the eye 
  5. Correct positioning of the artificial lens inside the eye (behind the iris)  
  6. Irrigation of the eye 

The tiny opening of the cornea at the edge closes up automatically after the artificial lens has been inserted. 

Laser surgery in Switzerland in our centres

Beau-Rivage | Lausanne

Eaux-Vives | Geneva

La Providence | Neuchâtel

Valère | Sion

Aftercare 

After surgery, patients are given eye drops to prevent any inflammation and to ensure their eyes are kept moist. A transparent eye dressing is also applied, which remains on both eyes for the first night. 

It is completely normal for vision to still be blurred immediately after the ICL implantation. However, this condition improves so quickly that most patients are already able to drive or go to work on the first day after the operation. 

Follow-up appointments with an ophthalmologist usually take place on the first day and one week after the ICL treatment. Two further follow-up appointments are then scheduled six weeks and six months after the procedure.

FAQs

Can an implantable lens slip or become dirty?

No, unlike a conventional contact lens, an implantable lens cannot slip or become dirty. However, patients who have undergone lens implantation using the ICL technique are advised to visit an ophthalmologist once a year for a check-up so that any symptoms or difficulties can be detected and treated in good time. 

What is an artificial/implantable lens made of?

The ICL is a clear, wafer-thin and highly flexible mini lens made of plastic (collagen); it resembles a contact lens.

Is visual acuity stabilised using the ICL technique?

If the artificial lens is implanted after the age of 25, it can be assumed that no relevant changes in visual acuity are to be expected and that this will stabilise. This does not apply in the case of natural age-related far-sightedness, but this only affects near-distance vision in old age and can be corrected with appropriate reading glasses.

What are the advantages?

  • High tolerability – the artificial lens is invisible and imperceptible 
  • Reduced incidence of dry eyes (especially compared with the Femto-LASIK procedure)  
  • Life-long effect 
  • High UV protection 
  • Correction of severe near-sightedness or far-sightedness possible in conjunction with astigmatism 
  • Full visual acuity is usually achieved much faster than with laser eye treatment 

What are the risks and side effects?

In the first few hours after the operation, a slight feeling of scratchiness or itching in the eyes is completely normal. Immediately after surgery, patients' vision is also a little blurred at first, which is due to the fact that the pupil is still dilated. 

Patients often already have a good level of vision after one or two days – stable visual acuity is usually achieved within the first month after the procedure. This is why the ophthalmologist agrees a time with the patients regarding when they are allowed to drive a car again. 

However, implantation of an artificial lens can lead to the following complications: 

  • Eye infections 
  • Increased sensitivity to light and glare 
  • Reduced night vision 
  • Over- or under-correction with the need for further surgery or subsequent wearing of corrective visual aid 
  • People over 40 may need reading glasses after the operation 

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