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Visian Implantable Phakic IOLs – Right For You?

The Visian ICL is an FDA-approved phakic IOL for the treatment of moderate to severe myopia (nearsightedness). The implantable lens is produced by STAAR Surgical Co. (Monrovia, CA).

The Visian ICL is also called an Implantable Collamer Lens (ICL), because of the unique material it is made of. The word "collamer" is a combination of "collagen" and "polymer." Collagen is a natural substance found in the cornea and lens of the human eye.

The flexible and biocompatible collamer material has characteristics that are nearly identical to those of the eye's natural crystalline lens, according to the company.

The Visian ICL was approved for use in the United States in December 2005. The lens is indicated for the correction of -3.00 diopters (D) to -20.00 D of myopia, with little to no astigmatism.

(A toric version of the Visian ICL for the correction of astigmatism, the Visian TICL, is currently available outside the United States and is under review by the FDA.)

Surgeons worldwide have performed more than 150,000 vision correction procedures with the Verisyse lens over the past 18 years, according to STAAR Surgical.

How the Visian ICL Works

Nearsightedness is caused by the cornea and lens having too much focusing power for the length of the eye. In a nearsighted eye, light is focused too quickly, before it reaches the retina, causing distance vision to be blurred. In severe myopia, the area of clear uncorrected vision may extend only a few inches from the eye.

The Visian ICL is a "minus-power" lens that is implanted behind the pupil and iris, and in front of the eye's natural lens. This space is called the posterior chamber of the eye. (The space between the cornea and the iris is called the anterior chamber.)
It reduces the combined light-focusing power of the lens and cornea, moving the focal point of the eye to the surface of the retina for clear vision.

The Visian ICL does not interfere with accommodating ability of the eye's natural lens, so the eye remains capable of seeing clearly at all distances in patients under age 40 who do not yet have presbyopia. (The Visian ICL procedure does not prevent presbyopia, so sometime after age 40, patients with the phakic IOL implant will need reading glasses.)

Although vision correction provided by the Visian ICL is intended to be permanent, the procedure is reversible and the lens can be removed if necessary.

The Visian ICL Procedure

The Visian ICL procedure is performed on an outpatient basis with no need for an overnight hospital stay. The procedure takes approximately 15 to 30 minutes.

The steps required for the surgery include:

  1. A lid retainer (called a speculum) will be positioned under your eyelids to keep your eye open throughout the procedure.
  2. Anesthetic eye drops will be placed on your eye to eliminate or minimize discomfort. You may or may not be given a sedative.
  3. The surgeon will create one or two small openings at the base of your cornea that will be used for inserting an instrument to position the lens.
  4. A gel-like substance will be inserted into your eye to protect delicate structures in the eye while the Visian ICL is inserted and positioned. This gel will be removed at the end of the surgery.
  5. A small incision will be made on the side of your cornea and the lens is inserted. (The Visian ICL is flexible and is folded prior to insertion, so only a very small incision is needed.)
  6. As the lens enters the eye, it automatically unfolds. Once it is completely unfolded, the surgeon tucks the four corners or the Visian ICL under your iris. Once the entire lens is behind the pupil, it is virtually invisible.
  7. Because the incision for the Visian ICL procedure is so small, sutures are usually not needed after surgery to close the wound.

After surgery, you will be given medicated eye drops to prevent infection and inflammation. A temporary shield may be placed over your eye to protect it. You may be asked to wear this shield at bedtime for several days after surgery.

You should not drive immediately after Visian ICL surgery, so you should arrange to have someone drive you to the surgical center and back home. Be sure to follow your doctor's instructions exactly to promote healing and minimize the risk of complications.

Typically, Visian ICL surgery is performed one eye at a time, allowing several weeks to pass before the surgeon performs the procedure on the other eye. However, some refractive surgeons will perform the procedure on both eyes the same day.

Effectiveness of the Visian ICL

In a clinical study of 294 patients who underwent the Visian ICL procedure:

  • 95 percent had 20/40 or better vision (the legal requirement for driving without corrective eyewear in most states).
  • 59 percent had 20/20 or better vision without glasses (three years after surgery).

Visian ICL Cost

Visian ICL surgery is considered an elective procedure. Therefore, most health insurance plans do not cover any of the costs associated with the surgery.

Many refractive surgeons in the U.S. charge approximately $3,500 to $4,500 per eye for Visian ICL surgery, which is higher than the average LASIK cost. This total fee includes all aspects of the surgery, including the lens and follow-up exams after surgery.

You can lower your cost of the Visian ICL procedure by setting up a Health Savings Account (HSA) at your bank or contributing to flexible health benefits program at work. Many refractive surgeons also offer financing programs that allow you to pay for the procedure over time at attractive interest rates or interest-free over a limited time frame.

Note: This information is for general education purposes only. It is not to be used as a substitute for medical advice from your eye doctor or refractive surgeon.

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