My experience on Implantable Collamer Lens (ICL) Surgery

ICL Surgery Experience

Hi, I have been receiving many questions regarding my surgery so I thought it would be best for me to jot it down. I did my research and read many reviews on the Internet. Most of the reviews claim the feeling of ants biting and some others express feeling pressure on the eyeballs. The pain was beyond my expectation especially during rotating the Collamer Lens.

TABLE OF CONTENTS

1.0 Difference between LASIK and ICL 2.0 Pricing 3.0 How did I come across this surgery 4.0 Pre-Lasik / ICL Consultation & Examination 5.0 ICL Simulation 5.0 Placing order for my Collamer Lens 6.0 Surgery 6.1 Preparation Checklist 6.2 Surgery Day 6.3 Surgery Aftercare

1.0 iLASIK vs ICL (Implantable Collamer Lens) Surgery

iLASIK	ICL Surgery
This method is used to create a corneal flap -> thinner  cornea. (iLASIK required certain thickness, mine was too thin for it)	No corneal tissue is permanently removed from your eyes. (ICL required “space” in your eyes, they will check it for you)

2.0 Pricing 

The price heavily depends on the degree of correction needed for your myopia, presbyopia & astigmatism.

I suffer from myopia (short-sightedness). My eyesight is 750, 400 astig (Left), 650, 350 astig (Right). The doctor recommended the ICL procedure over iLASIK for three reasons:
1) My cornea was too thin for iLASIK.
2) My eyes have more than enough “room” for the Collamer Lens to be inserted.
3) High astigmatism 

Original price was RM9,998 per eye, RM19,996 in total. However, I purchased my package during their carnival at a cheaper rate of RM8,998 per eye, total RM17,996 (on March 2018).

	Original	My package
Surgery Cost	RM19,996	RM17,996
Pre Examination	RM198	RM138
ICL Simulation	RM238	RM0
Total	RM20,432	RM18,134

Different correction methods

3.0 How did I come across this surgery

At the end of February, I felt discomfort on my eyes so I visited Vista Eye Specialist at eCurve for a check up. During the consultation, I asked about LASIK surgery because I have wanted to do it since the age of 14 but it requires a stable eyesight which usually happens after at age 20+. The assistant then brought me for a quick check up on my eyes health. 

      Another reason was that I had Contact lens intolerance—also known as CLI is a catch-all term for people who are no longer able to apply a lens to their eyes without pain. Many people who have common refractive errors such as short-sightedness, long-sightedness or astigmatism, and wear contacts lenses, have experienced some form of contact lens intolerance. This explains why I always wear specs since October onwards. 

4.0 Pre-Lasik / ICL Consultation & Examination

I scheduled an appointment on 3 March 2018 for Pre-Lasik / ICL Consultation & Examination. It was originally RM198 but I only paid a promotion rate of RM138. The process took 3 hours to identify the most suitable method for my eyes. It included tonometry (testing eye fluid pressure), checking pupil size, checking eyesight power & etc. 

The results were available immediately that my cornea was too thin & it would be risky for me to undergo LASIK due to my power. My surgeon - Dr Aloysius checked my eyes said that they were in perfect condition to undergo surgery. The normal ICL surgery costs RM7,998 per eye but if you have high astigmatism like me, you would have to top up another RM2,000. 

As I signed up for the promotion package, I was required to pay the full amount before 17 March. Otherwise, you can opt for monthly installment payment plans through specific banks.

5.0 ICL Simulation

I fixed another appointment on 28 March for ICL simulation. The idea of this simulation is for the doctor to know where the lens will be placed in my eyes. I had to lay off contact lenses at least 10 days before my appointment. When I arrived at Vista, I was brought to a rest area and one of the staff applied eyedrops for me. It is to dilute my eyes to enlarge my pupil. During the hour, you have must avoid looking at screens and close your eyes to rest (to get the most natural pupil state). This procedure normally costs RM238 but they were nice enough to waive these charges because I paid the full amount upfront.

After the hour, I was brought into a small room to lay down. Dr Aloysius came in to comfort me by ensuring that it would be quick and painless. Before the process, he told me all I needed to do was to look at the red dot on the ceiling so that he could use the machine to simulate where the Collamer Lens would be inserted. He began on my right eye, opening it with an object that looked like a funnel and flushed liquids into it. While I was looking at the red dot on ceiling with my left eye, Dr Aloysius used what seemed to be a scanner on my eyeball until the machine beeped. It took approximately 3 minutes for each eye. One of the staff gave me consent form and a preparation checklist for the upcoming surgery.

5.0 Placing order for my Collamer Lens

Right after the session with Dr Aloysius, I was told that an order for my lens will be placed today and the expected delivery period is 4 ~ 8 weeks (Each Collamer lens is custom made and shipped from Switzerland). On 11 April, I received a call from VISTA to inform me that my lens have arrived. It arrived in 2 weeks time! I scheduled my appointment on 25 April as I need to lay off my contact lens again 10 days before the surgery day. 

 Collamer is a 100% pure collagen copolymer material that is compatible with your body's natural chemistry (often called “biocompatibility.”) Because of this, it is “quiet in the eye,” meaning you won't even know it's there! Collamer is easy to implant because it unfolds gently and predictably in the eye.

6.0 Surgery

6.1 Surgery Preparation Checklist

You will be given a checklist of to-do’s & not to-do’s. Things like no alcohol 24 hours before, no makeup and perfume on the day, arrange on transport & etc. (common sense)

6.2 Surgery Day

On the day itself, I had to go for a final check up on my eye power to ensure it is stable and that it matches the lens I ordered. Like before, my eyes were diluted and many eye drops were applied including a numbing drop. After checking eye fluid pressure and eye power, i was brought into the waiting room and changed into a gown and hair net and left my specs in the locker.  Many patients were inside sitting at waiting area and I joined them. The assistant applied another few more eye drops into my eyes and shone a torch-light to check my pupil enlargement. Then, I was brought to a machine with Dr Aloysius. He briefed me on the surgery procedure and all I had to do was look vertically and give him passive reaction. He used a surgical marker pen to mark the incision spot on my left eye.

They assisted me to a smaller surgery room. Dr Aloysius began on my left eye. A transparent eye shield was taped on my right eye and a “sticky mat” was applied on my left eye to ensure my eyelashes were out of the area. The same “sticky mat” was stretched over my face to cover it and a cut-out was made according to my left eye exposing only my left eye. The area around my eye was cleaned and an instrument called a lid speculum was used to hold my eyelids open. 

SO HERE WE GO.  The assistant flushed liquids into my left eye and i could actually see the doctor’s hand with a small knife working on my eyeball even though i was told to look at the yellow light but it was not painful. Soon after he created tiny incisions, he told me to expect seeing a (I couldn’t remember what he said as I was freaking nervous and need full concentration). I knew the lens was inserted immediately because it felt just like wearing contact lens. However my vision seemed as if I was wearing goggles underwater and I saw many floating objects in the air. During the procedure, it was difficult for me to look vertically because the lights seemed to be moving. The painful part was when the doctor had to rotate the lens to the correct position. I felt some resistance and pressure on my eyeball. Fluids were being pumped into my eyeball throughout the surgery. It took a total of 15 minutes for my left eye. Then, I was brought to the waiting area to rest for 30 minutes and continue on my right eye after that.

I took a 30-minute nap and soon they woke me up for my right eye operation. This time I could feel that my eyes were too tired to open. Meanwhile, Dr Aloysius conducted a small “lecture” in the surgery room to some observants (I presume students) and I overheard the consequences of improper aftercare. I began to panic and I think Dr Aloysius noticed this therefore he tried to complete the procedure as quickly as he could. All in all, the process on my left eye was bearable but on my right eye, it felt more uncomfortable and painful than the left eye.

Overall the pain is 6/10 for my personal experience however my vision day after day is definitely worth the time and money.

6.3 Surgery Aftercare

Medication Kit included:

• 3 pills, consume every 6 hours.
• Sun visors, wear indoor for first 24 hours and followed by 1  week outdoor.
• Eye shield, wear it when taking a nap or sleep for the next 1 week.
• 2 eye drops (Zymar & Pred Forte). Apply every 2 hours.
• Routine check up after 1 day, 1 week, 1 month & 1 year. (no extra charges)

Things to avoid:

1. No swimming for a month.
2. No eye shadow / mascara for a month.
3. No contact sports.
4. Jogging can be resumed after 48 hours.

I had my after surgery check up on 26 April (1 day after my surgery) and doctor said it is all good! :)

They even provided my surgeon's personal contact for emergency purpose. I texted Dr Aloysius about my right eye is not as clear as my left and he replied promptly.  It is normal as one eye is dominant (more for distant vision) while the other is non-dominant (more active for reading).

Sekian, Terima Kasih.