My ICL experience

[ScottW]

Hello everyone, I'm a new user here but have read a lot about everyone's experience. I had Visian ICLs implanted on January 10, 2011 (1 month ago tomorrow). It was performed by a well-known surgeon here in Dallas (I'm withholding the name, as I saw it was edited out in another post). But, I think it's safe to say that this doctor has done corrective eye procedures for several years now and is very experienced.

Let me first start off by saying that my vision (when I don't have issues that I explain below) is perfect. When I am tested with using just one eye, I see 20/20 out of each eye. Using both eyes, I can read the 2nd row below 20/20 (not sure what that is). So, the procedure gave me great eye sight in the proper setting.

My eyeglass prescription was -9 in the left eye, -10 in the right eye. I was told by the doctor that they could do LASIK, but it wouldn't be as good of vision as the ICL. I don't know for sure, but it sounds like that is true, as I would have lost a lot of cornea cells to correct my vision (my cornea is a normal shape, I have a long eye, and it is thick, for what that's worth). Another factor in favor of the ICL for me was the ability to reverse it, even though there is some risk in that. At least I know there is some ability to fix it if the ICLs drive me crazy.

That being said, I do have some issues that I'm still dealing with. They are:

1. Double vision (maybe what some call "ghosting") out of my right eye. It's almost always there on the peripery, on the far right and bottom corner of my vision. My left eye doesn't have this issue (or enough to be noticeable). It's even worse in low light situations, like going from my dining room that is lit into a bathroom that is not lit - I can see a ghost image of the doorway out of my right eye. I'm not sure what is causing this, but it may be the size of my pupil at the time (but it happens in brightly lit rooms too), left over astigmatism (was supposed to be fixed during surgery), scar from the surgery that has not healed yet, or a cornal abrasion (I got this about 3 days after surgery) that has not healed yet. This is bearable for now, but bugs me throughout the day.

2. Glare that turns into halos. This usually starts as a glare that shoots out from a light source and can eventually turn into a halo if it's dark enough. I can get the glare while sitting in my living room watching TV with lights on - it's almost like my iris pulsates (gets bigger, then smaller, then bigger, etc.). In darkness (like night driving), this will happen and eventually turn into halos, but only 180 degrees on the nose-side of my vision (left side if I look out of my right eye, right side if I look out of my left eye). If I look at a bright light, it goes away as my pupil shrinks. I also get hazy halos in very dim situations, like sitting in my car to start it in my garage, when the dash lights come on. I believe this is caused by my pupils becoming larger than the visual area on the ICL. I have not yet started drops (like Alphagan P) to shrink my iris, so hopefully something like this will help. I'm just not excited about using drops all the time, and wondering if I'll need them to see well in my living room as I watch TV. Another possibility I want to explore is wearing special contacts with a dark band that will keep light coming in when my pupil dilates too much. I'm not sure if this will work, and it will mean wearing contacts, but I think it is worth pursuing.

By the way, I never noticed my pupils being large before the surgery, and my doctor didn't mention it as a risk, so I'm wondering if maybe my pupils are larger now for some reason and (if so) if they will shrink back down once my eyes fully recover. I'm led to this thought because my eyes are a bit more sensitive to the sun than they were before (I'm thinking that the larger pupils are letting in more light than they did before).

One oddity with the halos - if I wake up at night and it's very dark (i.e., my pupils are really large), I'll see halos that are a bit more than 180 degrees, and I'll also see a secondary halo in the upper left portion of my vision out of my right eye. Very weird.

The halos go from mildly amusing to annoying as they pop in and out. I'm not sure if I'd rather have them stay out as halos, or if I'm happy that I can get them to go down if I look at bright lights. I'm thinking it's the latter, as they can go down or away if I get to the right light situation. And, if my next vehicle has a bright dashboard (my now is very dim), it may help keep my iris constricted to further help with halos while driving at night.

3. I have dry eyes and some inflammation, but it's not too unbearable. I think the dry eyes are due to the cuts in the cornea, and I expect it to clear up in the next month or so. I'm still on Prednisolone twice a day, and I do eye drops every hour or two (Refresh Optive preservative free). As a side note, I'm left wondering if either of these are causing the ghosting or leading to larger pupils. Of the side effects, this one is very negligible and not a big concern for me.

4. My close-up vision is gone. I used to be able to read small print a few inches from my eyes, but no more. My near vision was worse after the surgery, but has not settled down to a normal range (based on how my wife reads, who has 20/20 vision without any correction). For example, I read books about a foot from my eyes. I tried reading glasses at first, but was told to stop as that is worse for my eyes at this point (I'm 37, by the way).

So I guess the ultimate question is whether I would still go through this again, if I knew then what I know now. I don't have an answer for that yet. One problem is that the blurriness and halos got worse in the last week. Over a week ago, they were annoying at night, but not really present in the day. But now they are more pronounced, or maybe I just notice them better because my vision otherwise is much more clear.

On the other hand, it's really nice to go without glasses. It's hard learning not to reach for them when I wake up, and it feels a lot different in the wind and rain (and even when I run the heat and air in my vehicle - I used to like to have it hit my face, but now that's bothersome). I also like not having the weight on my ears and nose from the glasses. Finally, my glasses gave me a fisheye view of the world, so the sides were warped in a bit because the glasses were so thick. The world looks much more normal now.

I see my doctor again next Wednesday (February 16). Hopefully I'll have some resolution on some of these issues, and can speak about the drops and contact lens to solve some of the glare and halo issues. For now, I am reading as much as I can and trying to stay patient.

If anyone has any thoughts or similar experience, I'd love to hear from you. I'll also update this once I see my doctor next Wednesday.

[susssan]

I don't have a lot of experience, having just had lasik in December 2010, but I think it may give you hope to know that now around 9 weeks after the surgery, my ghosting is getting much less. yay!
so maybe what you need is time.

[ScottW]

Thanks for the feedback. I'm still trying to be patient, as I realize a surgery is very traumatic to the body. I tore my achilles last year, and it took me 6 weeks before I could get the cast off and move my foot again. I can only imagine that a similar long time frame is needed for my eye to heal from surgery.

The biggest concern I have about waiting is that the ghosting and halos got worse for me last week. I'm not sure why this happened - maybe my vision cleared up enough to where I can see these issues more now, or maybe the inflammation has gone down enough that these are occurring more now as the pupil can dilate more. I just don't know.

I have done some testing of my own, looking at a ghost image, then looking at a bright light to constrict my iris, then looking back. The ghost is usually gone, which makes me think this all relates to the size of my pupil. We'll see what the doctor says next week when I go in for my next check-up.

[Rebecca]

Hi! I read your post shortly after having a Visian ICL implanted in my left eye on Feb. 1, 2011. I can't believe how similar our experiences are, and I actually joined this site so I could reply to your post! I am 26 years old, and have extremely high myopia in both eyes; my prescription is -19. It's difficult for me to see well wearing high index glasses, because everything is distorted and appears distant with my level of prescription. The vision I have with my contacts is very good, but I can't wear them for very long without my eyes becoming bloodshot and irritated. So, I decided to ask my doctor about other options, and she recommended I look into Visian ICl.

I did some research, and my eye doctor recommended I go to the leading eye center for refractive surgery in my area, which is close to Philadelphia. I knew I had a greater risk of complications because of my large pupil size and high myopia, and my surgeon at the eye center told me he would like me to be evaluated by a retina specialist before I moved forward. I was told by the specialist that everything looked fine and that I could go ahead. I had the LPIs done on January 13, and besides having a little glare in certain lighting conditions that wasn't there before the surgery, it didn't affect my vision. My surgeon recommended that I have the Visian lens implanted in one eye at a time, so I scheduled my left eye for a couple weeks later, on February 1st.

Immediately after the surgery I could see the clock on the wall, but I was aware of double vision and blurriness. I remember seeing 5 table legs on the end table sitting in the waiting room. I mentioned it to the nurse, but she assured me it wasn't unusual for right after surgery. During the days and weeks afterward, my main complaint was extreme double vision, or like you said, "ghosting". I also felt like it became even worse several weeks after the surgery. The ghost is so offset from the actual object, that I really would call it double vision. I have ghosting in dim lighting especially, but also in bright lighting, like in a grocery store or Home Depot. I often see ghost images of the doorways, (especially going from a well lit space into a darker room), and also an object that is a lighter color will ghost over a darker object that is near it. I also have halos, and glare that turns into halos, exactly like you described. The glare from the TV, even in a well lit room, is hard to deal with.


I basically feel like I have all of the issues that you've been experiencing, except the dry eyes and inflammation. The hardest thing for me is the double vision. My doctor hadn't mentioned it as a possible complication before surgery, and is not sure what is causing it. He prescribed Alphagan P drops, and they do make a big difference. I've been using them twice a day, though about a week ago it was 3 times a day. I know the drops lose their effectiveness after a while, but they still make an improvement for me right now. It's been 8 weeks since my surgery, and I have seen some improvement over the last few days. The halos have diminished a little too. I saw my surgeon a couple weeks ago, and he said the vault was good, and everything appeared as it should. One thing I forgot to mention earlier, is that my left pupil (with the Visian lens) now appears slightly larger than my right pupil. My doctor isn’t exactly sure why. He wants me to give it more time and to see him again in June. He has offered to remove the lens at any time. I've gone back and forth with that decision... sometimes I want it out right that minute, but at other times I see an improvement, and imagine what it would be like if it continued to improve. It's really hard right now because I still have my right eye with -19 vision and no ghosting. I have to wear a contact as much as I can, or a patch when it becomes too irritated. I'm going to have to decide in the not to distant future, whether or not to go ahead with my other eye. Right now, I'm trying to be positive and to give it more time. I was wondering how your doctor's appointment went, and how you are doing now? If anyone else has thoughts or a similar experience, I would really appreciate hearing from you.

[ScottW]

Hello Rebecca. Sorry for the delay in the reply, but I've been away from the forums for a while. My eye issues settled down quite a bit. I'm still suffering from occasional dry eyes (especially now that it's summer and extremely dry in Dallas), but the Refresh Optive drops help a lot for that. I'll put them in 3-6 times a day, and once before I go to sleep at night. I was in the Smoky Mountains a few weeks ago where it is much more humid, and I had absolutely no issues with dry eyes there. So my hope is that the eyes settle down after summer when it gets a bit more humid here.

My inflammation is also gone. Once I stopped the steroid drops, they calmed down. The biggest effect I still experience is the double image/ghosting. It's only when the light is dim (dark room, nighttime). But, most of the time I find myself ignoring the halos and other effects. Sometimes they bug me (like in my media room when it's dim, and the TV gets blurry), but most of the time I live with it. Some days, it's worse than others (and a lot of times it's a sign that my eyes have gotten dry).

All that being said, I think I'm happy that I had the procedure done. Yes, there are side effects, and some can bother you (and people have different degrees of how much it bothers them). But I get to live without glasses (mine were thick too), which is a big bonus for me. I get to watch 3D movies (they never worked for me before), wear regular sunglasses (I've got 5 different pair now), and not worry about losing or breaking my glasses, like on a campout or while swimming. I'd say that about 98% of the time, I don't notice anything about my eyes, and the other 2% is managable.

Regarding your issues, I'm wondering how your eyes are working now that it's a few months later. Hopefully the issues have gone down or away for you.