Implantable Collamer Lens (ICL) A Review of Its Indications and Complications

Abstract

Refractive error correction has become a long standing debate, from the traditional use of spectacles and contact lenses to the era of LASIK. An alternative for the refractive errors' management is the phakic IOL. Phakic intraocular implants overcome the disadvantages of corneal refractive surgeries and have been shown to correct ametropia successfully . Phakic IOLs are considered an attractive approach, based in large part on the phenomenal acceptance of IOLs for not only the aphakic or cataract patient but also the refractive patient. The use of phakic IOLs offers the predictability and efficacy of IOL technology, yet is less invasive because the crystalline lens is left intact. In addition, the procedure is reversible /exchangeable, and if the crystalline lens is damaged during phakic IOL implantation, lensectomy with IOL implantation remains a good second option. The Implantable Collamer Lens (ICL) is another type of Phakic Intraocular Lens which is manufactured from a soft foldable polymeric material called Collamer. The cornea is actually comprised of collagen and so this material provides excellent biocompatibility and superior optical capability. The ICL offers a non corneal option for refractive correction. Current versions of the ICL are available between -3.00 and -20.00 diopters (D) and +1.50 to +20.00 D.A toric model, which corrects up to 6 D of astigmatism, is available. The ICL’s extended range of correction offers a compelling alternative for patients outside the accepted range of laser in-situ keratomileusis (LASIK). It is readily implanted behind the iris by gently folding it and injecting into the anterior chamber through a tiny incision only 3.0mm in length placed by the surgeon at the clear edge of the cornea. ICL implantation induces few halos possibly because it maintains the shape of the cornea, regardless of the amount of myopic correction. The incidence of cataract with the ICL has varied from 2-3%. Several mechanisms have been put forward to explain