ICL

ICL stands for “intra-ocular contact lens” but is a misnomer, because it has nothing to do with contact lenses. The only reason it’s called this misleading name is for marketing purposes, to make it sound safer than it is.

ICL involves cutting an incision into your eye with a metal knife through the sclera or white part of your eye, or with a diamond knife through your cornea or clear part (on top of your iris or colored part of your eye). Because this is a cutting step, it can cause bleeding if in the white part of your eye, or the fluid in your eye leaking out after surgery if in the clear part of your eye.

The surgeon must carefully place a hard piece of plastic (a PMMA IOL) into a tiny potential space that’s only about 1mm wide, between your natural lens & iris. If he hits your lens with this fake plastic lens, he might cause a cataract, which is a bad complication that would require additional surgery to prevent loss of vision, and that surgery would destroy your ability to focus up close in that eye. If he hits your iris during insertion, he can cause significant bleeding or permanent iris damage, causing you to have a cosmetically disfigured iris—and, again more surgery (& expense) to fix it.

Even if surgery goes well, the fake hard plastic lens might sit in the wrong position, so that when your iris dilates & contracts many times every day due to changing lighting conditions, the front of the plastic rubs against the back of your iris. Over time, this can rub off enough pigment off your iris as you cause a cosmetic deformity or visible hole in your iris, night glare from that hole, or even glaucoma or bleeding. Or the back of the plastic can still touch the front of your natural lens, again causing a cataract to cloud your vision. In either of these cases of lens touch, it will be necessary to have a second operation to explain or remove the PMMA IOL (fake lens). This is why all honest eye surgeons agree that “implantable contact lens” is a misnomer—because if the “ICL” contacts anything, it results in a complication requiring a re-operation.

But the above bad possible complications from choosing to have “ICL” surgery isn’t the most dangerous thing—which is if you have an infection after ICL surgery, it will be intraocular, or inside your eyeball, because when the lens is inserted into your eye or afterwards, bacteria can be introduced into the inside of your eyeball through the cut that was made. Then you’d need injections of antibiotics into your eyeball. But if these bacteria are drug-resistant, the antibiotics won’t work—and you might go blind.

Dr. Chynn implanted his first ICL (Intraocular Contact Lens) in 2000, but wasn’t happy with the results of the early lenses, as they were difficult to implant, and often required explanation (removal). This was due to poor fit, causing movement of the plastic lens in the eye, which could result in iris pigment being rubbed off, which could cause unsightly iris trans-illumination defects (TID’s), and pigment dispersion syndrome, leading to pigmentary glaucoma. In rare cases, the lens would chafe against the blood vessels in the back of the iris, causing bleeding & “UGH syndrome” (which is as bad as it sounds).

Contrast all of the above possibly blinding complications from ICL surgery with LASEK. LASEK is an extra-ocular procedure, which means it happens on the exterior surface of your eyeball—not inside as with ICL. Therefore, none of the possibly blinding complications of ICL are even possible with LASEK.

Iris damage is impossible, because we aren’t going into your eyeball. Cataract formation during surgery is also impossible for the same reason, as is surgically-induced glaucoma, intraocular bleeding, or an infection inside your eyeball or endophthalmitis. Therefore, blindness is impossible after LASEK (but not after ICL).

If you get an infection after LASEK, we can always kill off any bacteria, because the infection will be on the surface of your eye. Therefore, even if the bacteria is resistant to antibiotics, we can kill it with antiseptic drops like Betadine (iodine) or alcohol. You can’t use these inside the eye, as they would cause blindness.

Dr. Chynn has safely treated hundreds of patients with myopic or nearsighted prescriptions up to -19.75, astigmatism up to 5 diopters, & hyperopia or farsighted prescriptions up to +6.00. Twenty years ago, when he was still performing LASIK, his effective safe limits were respectively -8.00 for myopia, 2.50 diopters for astigmatism, & +2.75 for hyperopia.

That said, if your Rx is past -19.75, 5 D of astigmatism, or +6.00, you do not qualify for the safer LASEK procedure, and your only option is ICL.

Recently, in 2022, FDA approved the STAAR EVO and EVO+ Visian Implantable Collamer Lens ICL, so Dr. Chynn is now more enthusiastic about ICL implantation, because this newer lens design has a lower incidence of complications.

Dr. Chynn is the only eye surgeon in the NY Tri-State Region who specializes in treating extreme prescriptions, which are well past safe treatment parameters for LASIK. Indeed, every week he is successfully eliminating the entire prescription of some patient with a prescription between -9.00 and -19.00 –even with astigmatism! He is achieving this quickly, painlessly and safely, either with LASEK or with ICL.

Please be advised that ICL is significantly more expensive than LASEK, as it is an intraocular procedure, so must be performed in a sterile operating room, not just a “clean” laser suite for extra-ocular (outside of the eye) LASEK. So if you qualify for both LASEK and ICL, the latter procedure has a quicker recovery, but will cost much more.

Dr. Chynn is the only eye surgeon in NY, NJ or CT who will accept medical insurance as partial payment for LASEK (medical insurance will almost never cover ICL, as it is considered cosmetic). So if you have good medical insurance with a low deductible, this will reduce your cost for LASEK by at least $1,000.

Park Avenue LASEK is the only center in the NY, NJ or CT which will “buddy you” up with a happy former patient once you come in for your Consultation, so you can speak directly to that patient, who has already had either LASEK or ICL for extreme myopia, is happy to share his or her experience, and has no financial incentive whatsoever if you decide to proceed!  We have patients flying in from other states and other countries every week to have Dr. Chynn evaluate them for LASEK or ICL, because they failed to qualify for LASIK. So we have dozens of nice people willing to speak to you!

“Treating patients who can’t get LASIK is among the most rewarding surgeries that I perform,” says Dr. Chynn. “We always allow the extreme prescription patients to bring a loved one into the laser suite to literally hold their hand during the 5-minute procedure, and then they often film a ‘sit-up’ video. That’s the moment when they sit up from their procedure, open their eyes–and cry with happiness and disbelief”.

So if you were told that your prescription is too high for LASIK, or your cornea too thin, or you are a “bad candidate” or “do not qualify” for LASIK, DO NOT give up hope! You will PROBABLY be a GREAT candidate for LASEK or ICL! Call (212) 741-8628 M-F from 9am-5pm EST to schedule your consultation. And give us your medical insurance information so we can see if it will help cover the cost! 🙂