Dr Ang Pek Kiang Leonard
Singapore has one of the highest rate of myopia. At 7 years old, about 20% of children in Singapore are myopic and more than 70% are myopic upon completing college. People with myopia see better at near while distant objects are blurred. This is the most common form of refractive error among Singaporeans and Asians.
Apart from myopia, other commonly cited refractive errors include astigmatism and presbyopia (lao hua). Astigmatism occurs when the curvature of one part of the cornea is different from another, resulting in light rays being focused at various points in the eye. This condition leads to blurring and distortion of the image.
Presbyopia refers to a progressive difficulty in focusing on near objects and reading as one grows older. It is the result of an age-related decrease in the elasticity of the lens and weakening of the eye's focusing power, and usually starts at about 40 years of age.
One safe and effective method of correcting vision is the implantation of a phakic intraocular lens. The most widely established phakic intraocular lens is the EVO Visian implantable collamer lens, more commonly called implantable contact lens (ICL).
Once implanted, the lens is invisible to the naked eye and patients can resume all their normal activities.
ICL can correct a wide range of refractive errors of up to 1,900 degrees of short-sightedness and 500 degrees of astigmatism. It is particularly useful for people with high refractive errors (ie. those above 900 degrees) or people who are not suitable for LASIK due to very thin corneas.
For people with very high degrees, ICL surgery can give patients high-definition vision in the day and night, with less night vision disturbances (eg. haloes and starbursts) as compared to LASIK.
ICL can be used to treat:
ICL surgery is done by an eye surgeon under a mild topical or local anaesthetic.
The surgery is simple and painless and each eye takes about 5-10 minutes to complete. Once the anaesthesia is administered, your surgeon will insert the lens through a small incision at the edge of the cornea. The lens is placed behind the iris and in front of the natural crystalline lens.
The small incision does not require stitches and heals on its own. Eye drops or ointment will then be given and the affected eye will need to be covered with a patch. You will then be taken to the recovery room to be monitored for a few hours.
You can go home on the same day, but will have a follow-up appointment the next day. Your doctor may prescribe you with eye drops or oral medication for the pain.
Recovery is relatively fast with minimal discomfort. Patients can resume their normal activities the day after surgery, and most patients are able to return to work or school within 1-2 days of the procedure.
There are numerous benefits of having an ICL surgery, in addition to improved vision.
An ICL can correct a wide range of refractive errors, including severe nearsightedness (myopia) that can’t be corrected with other surgeries.
For those with chronic dry eyes, ICL is a good option as it does not affect your tear function. People who are not eligible for laser eye surgery will likely be good candidates for ICL.
The procedure itself is simple and recovery is usually quick as it does not involve any removal of tissue. Although an ICL is meant to be permanent, it can be removed if needed.
Short-sightedness, far-sightedness, lao hua, astigmatism – these are commonly cited refractive errors that can be corrected with ICL even in the most severe of cases, so you can bid those cumbersome glasses and contact lenses a permanent goodbye.
In the hands of an experienced surgeon, ICL surgery is very safe. Some potential complications that may occur include accelerating cataract formation, glaucoma (high eye pressure), cornea swelling, eye infection and inflammation. However, these complications are all treatable.