LASIK eye surgery, a popular method in Singapore to treat myopia, is not suitable for everyone.
Myopia is another word for short sightedness. It is a condition when a person sees near objects clearly but distant objects appear blurred. Severe myopia, thin or abnormal cornea or dry eyes eliminate the option of Lasik.
Those who cannot go for Lasik can opt for the Swiss lens the Implantable Contact Lens. In this procedure the ICL is inserted behind the iris into a natural space in the eye. The ICL can correct myopia, hyperopia and astigmatism.
The lens is made of a material knowncollamer, similar to collagen, and is biocompatible with the body. The procedure takes just 10 minutes under either general regional anesthesia.
Says Assistant Professor AlohamadRosman, head and senior consultant in the Refractive Surgery Department and Laser Vision Centre. Singapore National Eye Centre (SNEC)" ICL is able to treat very high degrees of myopia up to 2300 and astigmatism of 600". Compared to Lasik, he says they try to treat below 1,000 degrees as the predictability of someone with high myopia getting 6/6 vision is lower compared to a person with a lower degree of myopia
ICl does not involve thinning the cornea and poses no risk of weakening it. The procedure is also reversible, meaning that the lens can be exchanged in future when the patient with age develops presbyopia. Dr Cheryl Lee, the cataract, retina and Implantable contact lens specialist at Pacific Eye Centre. Says "When we grow older we will have reading vision problems. The advantage of the reversibility of the ICL is that it can be replaced with a multifocal intractable lens. This is not an option for patients who have had Lasik due to issues of the cornea post-surgery-Post-Lasik patients can still do ICL it choir eyesight regresses, sheds.
Prof Rosman says" We use ICL in cases where people can't do laser refractive surgery on the cornea." A patient who works in advertising says her doctor recommended she goes for ICL as her cornea was too thin and eyes were dry and she did not qualify for Lasik.
Her degree was around 1400 to 1600 and, she alternated between wearing glasses and hard contact lenses. "I was really looking forward to not having to pluck my dry lenses from my eyes at the end of each day "she says. After the procedure in 2011, she doesn't have to take care of her lenses every day and can play sports without her glasses getting in the way.
Dr Lee who sits on the ICI Expert panel where she teaches and moderates for research meetings on ICI says "When a patient is keen on ICL, I would advise them to watch a video on our website, which explains the differences between ICI and Lasik. We will then proceed with a suitability test and ultrasound to measure the size of the eye to customize the ICL to the patient" (https://theeyeclinic.com.sg/index.php/en/implantable-contact-lens/why-choose-icl)
Her patients range from 18 years, especially youth before entering National Service, to about 50 years. She also has patients from as Russia, Mongolia and Switzerland coming to her clinic for ICL. For the last four years, she has created awareness about ICL by giving public forum talks once a month. However, Prof Rosman recommends that people opt for contact lens implants only if they are unsuitable for other corneal refractive procedures such as Lasik. Epi.Lasik and Rel.Ex Smile
Epi-LASIK is similar to Lasik but does not create a corneal flap like Lasik while ReLax Smile is a 25.minute laser operation that removes a small amount of corneal tissue through a tiny incision, to correct shortsightedness from 100 to 1.000degrees. Corneal-based procedure gives very good results if performed on suitable patients.
The issue with ICI is that although risks are low, any complications that may occurred more significant and maybe more difficult to manage as it is an intraocular procedure involving the inside of the eye. 'Why subject patients to more significant risks if the outcomes are similar?" he adds. The cost of ICL is also much higher than Lasik. From about $5,000 per eye, where as Lasik starts from around $1200."
ICL may cause an increase in eye pressure and there may be related risks of cataract or glaucoma if the size of the ICL is incorrect.
To prevent these issues from happening, Dr Lee has a ultrasound which accurately measures the size of the eye to ensure the ICL size is also repeats the ultrasound a month after the procedure to prove to the patient the accuracy.
There is also a less than one in 1,000 chance risk of infection as the procedure is performed in a sterile operating theatre says Dr Lee-Aeschlimann.
The night vision symptoms such as halos and glares may affect the patient for a few weeks after surgery which is much less than in Lasik.
The unique advantage of ICL unlike corneal based surgery is that the cornea is not destroyed. It's important to think long term and not just the short term outcome.
The difference is in corneal based surgery the side effects are due to the corneal destruction that cannot be prevented as it's part of the process. In ICL the complications can be prevented as it's down to measurements and surgical skill of tjr doctor.
Ask yourself if you want the option of not wearing reading glasses when you reach 50. Also would you want your dry eyes to worsen with age, especially for women when you reach menopause?
If the answer is no, then the ICL is the option for you. It's more technically demanding and requires more experience so to get good results,you need a doctor with expertise.