Let's start with the question you did not ask: Why do you want an ICL?
The
Visian ICL (Implantable Collamer Lens) is a class of lenses called phakic intraocular lenses (P-IOL). These lenses are placed inside the eye behind the cornea (clear front) and in front of the natural lens within the eye.
Primary advantages of P-IOLs are that they are able to treat very high myopia (nearsighted, shortsighted) vision and that they allow the patient to accommodate. Accommodation is when the natural lens within the eye changes shape to change focus, thereby allowing a person to see objects near. Most people who cannot accommodate need reading glasses or bifocals to see objects near. The loss of accommodation, called presbyopia, occurs naturally at or past the age of 40.
P-IOLs tend to be best for persons who are relatively young (under age 40) and have high myopia. Without these two conditions, other vision correction surgery may be more appropriate.
P-IOLs are temporary. They must be removed on at least two ocassions. One is when cataracts form (a natural occurrance related to age) and the other is if they have caused the endothelial cells on the underside of the cornea to diminish in quantity to the point that corneal health is a concern. And therein lies the rub...literally.
Becuse P-IOLs have demonstrated that they can accellerate the loss of endothelial cells, it is vitally important that the surgeon perform an endothelial cell count before deciding if P-IOL surgery is appropriate and on a very regular basis (every other year or as required) to monitor endothelial cell loss after surgery. When approved by the FDA, a chart was created with reference to cell count, age, probable years of use, etc.
Since this is an important issue, when selecting a surgeon to perform P-IOL surgery, you want to ask if s/he will perform an endothalial cell count preoperatively, immediately postoperatively, and on what schedule thereafter.
A competent doctor will explain all this to you with the specific information relative to your unique circumstances, but you need to be sure that you select a doctor who is competent in this regard. You may also want to use our
50 Tough Questions For Your Lasik Doctor as a guide to surgeon selection.