LASIK vs. ICL Surgery

As our knowledge about eye surgery increases, new technology and surgical procedures are invented and investigated. The latest in eye surgery is the Visian Implantable Contact Lens or ICL, which was originally designed for patients who were not candidates for LASIK surgery. But more and more surgeons are beginning to offer ICL's to patients who are good LASIK candidates.

Advantages and limitations of LASIK

LASIK is an excellent way to correct vision and reduce the need for glasses and contact lenses. What makes it a good surgery? What are the limitations?

Advantages of LASIK

• Accuracy is excellent
The vast majority of patients have a near perfect outcome with one surgery. Reoperations are unusual.
• Quick Recovery
Great vision within a few hours, with patients seeing nearly 20/20 by the next day. Little or no pain.
• Permanent
Once the laser does its work, the change to the cornea is permanent.

Limitations of LASIK

• Range of nearsightedness
Most LASIK surgeons agree that LASIK should not be performed over -10.0 diopters. Many surgeons indicate that they are worried about the safety at -8.00
• Glare and Halos
Changing the natural curve of the cornea with LASIK induces aberrations that can lead to glare and halos, especially with night driving. This change is irreversible.
• Permanent
For better or worse, the changes that LASIK induces are permanent. This means that any bad side effects cannot be fixed. Once the cornea has been thinned with laser, the tissue is gone forever. This has created a particular problem when surgeons need to calculate lens implant power for post-LASIK cataract patients.
• Medical contraindications
Patients with many medical conditions such as lupus, Crohn's disease and Rheumatiod disease cannot have LASIK surgery. Patients with dry eye syndrome are at high risk for complications

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Advantages and limitations of ICL surgery

ICL surgery is also an excellent way to correct vision and reduce the need for glasses and contact lenses. Here are some of its advantages and limitations:

Advantages of ICL's

• Accuracy is excellent
The vast majority of patients have a near perfect outcome with one surgery. Reoperations are unusual.
• Quick Recovery
Great vision within a few hours, with patients seeing nearly 20/20 by the next day. Little or no pain.
• Less visual side effects
Glare and halos are less common with ICL's because they cause less aberration in the eye. Night vision has been shown to be better in ICLs as well.
• No effect on future surgeries
Since eye shape is not changed, there is no effect on other future surgeries, such as cataract surgery.
• Permanent
Once the lens is in place,, the change in nearsightedness is permanent.
• Reversible
If a problem does occur, the lens can be removed. Since the eye has not been significantly changed, it returns to its preoperative state.
• Less Medical contraindications
Patients with dry eye syndrome do not need to worry that their condition will worsen with surgery. And patients with some of the other medical contraindications for LASIK are candidates for ICL

Limitations of ICL

• Range of nearsightedness
The ICL can be used in patients with -3.00 to -20.00 diopters of nearsightendess
• Cost
ICL surgery costs about double what LASIK surgery costs
• Cataracts
0.4 percent of patients in the FDA study required cataract surgery after ICL surgery.
• Shorter track record
Dr. Goldstein performed the first ICL surgery in Michigan in 2005. The first LASIK in Michigan was performed around 1996. European and Canadian studies show great long-term results with ICLs

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Conclusions

Both LASIK and ICL surgery have advantages and disadvantages. Time will tell which one is truly the best choice for patients, but careful research by patients and surgeons alike is needed to ensure the best outcomes for all of these patients.