Thursday, September 18, 2008

Alternative to Lasik for Nearsighted People . . .


If you are one of the many people who long for the days when you could see clearly without glasses or contacts, there's something new in corrective eye surgery. In December 2005, the US Food and Drug Administration (FDA) approved the Visian Implantable Collamer Lens (ICL). Although the Visian ICL is currently approved only for nearsightedness, doctors anticipate that it will soon be FDA-approved for farsightedness as well.

To learn more about this new option, I spoke with board-certified ophthalmologist Deborah DiStefano, MD, who already has performed a number of lens implants in her Chattanooga, Tennessee, practice. In her experience thus far, ICL is both safe and effective.


According to Dr. DiStefano, contact lens implants are an excellent alternative for people who are not good candidates for LASIK (laser-assisted in-situ keratomileusis), the most common type of refractive eye surgery. When your vision is too poor you may not have the best results with LASIK (which works best in those with mild to moderate vision problems). When your cornea is too thin or not the right shape for LASIK, implantable contact lenses may be the answer.


Implanting a contact lens takes only 10 to 15 minutes, says Dr. DiStefano. To begin, the surgeon numbs the eye with concentrated anesthetic drops. Next he/she makes a tiny incision to place the ICL in front of the eye's natural lens. The contact lens is rolled up like a little cartridge, explains Dr. DiStefano. When the surgeon inserts it through the incision, it unfolds like a flower petal in the eye. The lens is made of a proprietary, highly biocompatible Collamer material.

The procedure is not painful, and there is instant gratification. After years of visual impairment, patients almost immediately have 20-40 vision or better, which Dr. DiStefano refers to as "the wow factor." Within three years, more than half of people's vision improves to 20-20. Another advantage: The lens lasts "forever," though the procedure is reversible and the lens can be replaced should the cornea change or you develop a cataract. Because there is only a tiny, microscopic incision involved, there is a correspondingly minute degree of scar tissue -- even less than that of cataract surgery.

There is always a small risk for infection with any procedure, although infections were rare or nonexistant in clinical trials of the ICL. Another rare but potential complication is a nick to the eye. After a two-week recovery period, there are no activity limitations with the implanted lenses.


As with any procedure, you are best off in the hands of an experienced surgeon. Dr. DiStefano recommends that you choose an eye center that performs a variety of procedures, has the most up-to-date equipment and practices the latest technologies. Because ICL procedures are elective, there is little likelihood that your insurance will cover it. Depending on your geographical location, the out-of-pocket cost ranges on average from $2,900 to $5,000 per eye. Dr. DiStefano's patients think that the wow factor is worth it.


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