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STAAR® (Surgical Technologies and Applied Research) Surgical's new VISIAN ICL™ (Implantable Collamer Lens) is providing the only foldable, minimally invasive, most anatomically correct lens available to qualified nearsighted patients all around Mississippi. From Jackson to Hattiesburg and points beyond, patients who don't qualify for LASIK are walking in with glasses and walking out without them.

Laurel resident Debbie Morgan, 40, is one of them.

"I've worn glasses since the second grade. I couldn't see in front of me or the alarm clock or go to the bathroom. After the first eye was done I left and came back a few hours later to be checked and my right eye was seeing 20/15. After the next eye was done it was seeing 20/20. I still wear reading glasses for small print, but other than that I don't wear any. For me, because my vision was always so bad, it's a miracle. It's made everything easier as far as life."

VISIAN ICL is a great alternative for patients who can't have LASIK because of dry eyes, thin corneas or large pupils. Requirements for the VISIAN ICL procedure are patients with from a - 3.0 to a - 22.0 diopters of myopia. A battery of tests is given to determine nearsightedness, corneal thickness, and other factors prior to surgery. And, unlike the 6.5 mm corneal incision required in the Verisyse™ procedure, VISIAN requires only a 3 mm incision, so no sutures are required. And, the VISIAN implant goes between the iris and the lens making it virtually undetectable.

While some physicians do each implant on back-to-back days and others space them a few weeks apart, none do both implants on the same day.

Hattiesburg corneal specialist Dr. Byron Smith of Southern Eye Center has now done between 35 and 40 of the VISIAN ICL procedures with zero complications.
"There is a possibility of blocking the fluid flow with this procedure so to prevent this we do laser iridotomy the week before. The next week we make sure the little holes made didn't close back up and if that looks good we'll do the implant in one eye," Smith said. "The third week we'll do an iridotomy in the next eye and then check it on the fourth week and do the implant in that eye if that still looks good. It's four visits."

Patients are given a sedative before surgery and numbing drops. Tylenol® is suggested for any discomfort. From prep time to post-op, patients usually leave within two hours.

Smith said potentially anyone on a negative vision side could get ICL, but that doesn't mean they should all do it.

"Patients with a - 7.0 should consider being examined for the VISIAN ICL, but anyone below that may be a better candidate for LASIK," Smith said. "Sometimes a little laser is required after the ICL procedure for minor adjustments, but only in 5 percent of the cases. Ninety-five percent require only the ICL."

Also, as with any medical procedure, there are pros and cons. LASIK procedures flatten the cornea by evaporating tissue. ICL doesn't remove any tissue. There is zero risk of infection inside the eye with LASIK. There is a 1 in 5,000 risk of infection inside the eye with ICL and, since there's a risk for pupillary block, peripheral iridotomy is required first. LASIK can never be undone. ICL can be undone at any time. And, ICL is only one-half a diopter of power so correction won't be as accurate. LASIK is accurate up to one-eighth of a diopter. In addition, ICL is a little more expensive than LASIK.

"Some of the happiest patients I have are the ICL patients. They can see better than ever before. We're in a renaissance of refractive surgery," said Smith.
Joe Cole, application specialist, with the Monrovia, Calif.-based STAAR, was in Memphis to oversee the first cases.

"We designed this procedure 15 years ago and over 55,000 cases have already been performed internationally," said Cole. "The United States is always the last to get any type of technology because it's the most stringent when it comes to studies. Our success rate for people who are moderately or extremely satisfied is 99 percent with less than 1 percent complication. We now have a 'Toric version' of the lens submitted for FDA approval that will correct astigmatism."


April 2007

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