The ICL procedure

Visian ICL surgery is safe and predictable, but like any sort of surgery carries a small risk of complications. The risk of a serious infection within the eye is small and less than refractive lens exchange surgery. In some cases the ICL may need to be exchanged if it does not fit well once it is in the eye. A small percentage of patients may also develop cataract or high pressure after surgery. As with any surgical procedure these risks are reduced by picking an experienced consultant surgeon.

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ICL surgery is quick and painless. It can be performed under local or general anaesthetic, depending on the patient. We do not operate on both eyes at the same session, and there is no overnight stay. For patients requiring surgery to both eyes, we specify a minimum 4 days between operations.

Time off work

It is advisable, though not obligatory, to take up to 3 days off work after each ICL implantation. Although you will be physically able to do most kinds of work from the day after surgery, and you will not harm your eyes by using them to read or watch a screen, the eyes may feel slightly gritty , and your eyes may still be light sensitive in the first week after surgery. These feelings of mild discomfort settle quickly.

Do not wear any eye or facial make-up on the day of surgery. Ordinary non-prescription sunglasses are useful whilst your eyes are mildly light sensitive in the early recovery period, and are ideal for travelling home after surgery, so bring a pair with you.

For patients having the procedure under general anaesthetic, a period of six hours without food and drink is usually required prior to surgery. For patients having local anaesthetic, eye drops are instilled, which produce a mild stinging sensation for about 10 seconds. Drops are usually placed in both eyes.


The ICL procedure

You will lie flat, with your head on a specially designed rest. A sterile plastic adhesive sheet is placed over the operated eye. This sheet has a non-adhesive section, which covers the other eye, your face, head and neck. The sheet is lifted well clear of your mouth and nose and should not make you feel too enclosed or claustrophobic. A speculum (eyelid retainer) is placed to help keep the eye open during the procedure. Blinking is no problem, but it is helpful if you can keep the facial muscles relaxed, and avoid squeezing the eyes shut during the procedure. The anaesthetic eye drops help you to do this comfortably. Light sedation (intravenous tranquilisers) is usually administered by the attending Consultant Anaesthetist (Dr Callagher or Dr Catteruccia) to help you to relax more during the surgery.

A microscope light will be switched on, which may be very dazzling at first, so it is often helpful to look away for 30 seconds before looking straight up into the light. Mr Maurino will talk you through this. You should stare straight up at the light throughout the procedure. This will keep the eye in the ideal position for the surgery. Blinking is no problem, but it is helpful to keep both eyes open between blinks. Closing the other eye will tend to cause the operated eye to move, so it is best to stare straight ahead with both eyes open. Some movement is normal, and will not be a problem, although excessive movement will tend to slow the procedure down. Mr Maurino may occasionally choose to freeze the muscles around the eye, in addition to numbing the eye’s surface, in order to complete the operation. This is achieved with an injection of anaesthetic behind the eye. Although this may sound unpleasant, it is usually straightforward and pain-free. Many surgeons and anaesthetists administer these muscle blocks routinely in all their patients.

Although you will feel the surgeon touching around the eye, and sensations such as mild pressure in the eye and fluid running over the surface of the eye, the operation is not painful. You will not see any formed images of surgical instruments. Patients usually report seeing brightly coloured lights at various stages during the surgery, but you may see nothing, particularly if local anaesthetic injection techniques are used.


                                          SEE A VIDEO OF THE ICL PROCEDURE




After the operation

At the end of the procedure, the surgeon will remove the adhesive sheet, and place a plastic shield over the eye. This dressing can be removed to go home, around an hour after the end of the surgery. Visual recovery after ICL surgery is rapid. Patients can commonly see at the driving standard or better within just 2 days of surgery. Mild, gritty discomfort is normal, and eye may be relatively light-sensitive in the first few days after surgery. Beyond this, any postoperative discomfort should be minimal. Antibiotic and anti-inflammatory eye drops are normally instilled four times a day for the first 3-4 weeks after surgery.

Eye rubbing should be avoided for the first month after surgery, and an eye shield is normally worn to protect the eye at nights for the first few weeks. Restrictions on activity are few. Swimming is not recommended in the first 3 weeks after surgery (because of a theoretical risk of infection), but other forms of exercise and flying are no problem. Try not to open your eyes under the shower, and avoid eye bathing – just use the prescribed drops to clean the eye itself and clear any mucous build up from the eyelids using a cotton wool bud moistened in cooled, boiled water.

Routine follow-up appointments

Review visits are normally required at 1 week and 4-6 weeks for each eye after surgery. Thereafter, annual review visits are performed to check for any signs of an adverse reaction to the ICL but the latter will be subject to usual follow-up consultation charges.

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