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A permanent fix to failing eyesight

February 7, 2008 8:40:35 PM PST
For nearsighted patients who are tired of glasses or contacts but haven't been able to have eye surgery, there's a new option. Doctors are implanting a special new type of lens that allows patients to see.

"I'm basically nearsighted so I can see everything near but nothing far," says Merrick Rustia.

Rustia has worn contacts for 20 years, but as an avid surfer, contacts don't work well for him.

"Basically I'd be in situations where I'd be in remote areas of the world. If I'd lose one in the water, I'd have to either paddle in and change them out to get a new one in to see again," says Rustia.

He's tried several times to get Lasik surgery but was turned down.

"They said my tissue, my cornea tissue, wasn't thick enough to do the surgery. So I wasn't a very good candidate," says Rustia.

So now, San Francisco eye surgeon Steven Chang will be using a new procedure to correct Rustia's vision using a permanent contact lens. His left eye was done last week, now his right eye will get the new lens.

"It corrects the vision just like Lasik does except it's placed inside the eye so you don't have to maintain it," says Dr. Steve Chang, an ophthalmologist and cataract specialist.

The lens is called Visian ICL, or implantable collamer lens, but it's better known as the implantable contact lens. It's been used in Europe and other parts of the world for more than 15 years and now has FDA approval.

"It's made out of collagen-type of material which is a similar type of material that the eyes are made out of," says Dr. Chang.

Before surgery can begin, Dr. Chang has the delicate job of loading the rectangular-shaped contact lens into a cylinder. He carefully folds the lens into the cylinder's barrel and then gently pushes into a loading chamber. Next he has to pull the delicate lens into its final position in the cylinder and then finally attach the cylinder to the loading cartridge. Now the surgery begins.

"We make a very small incision right where the white of the eye meets the colored part of the eye," says Dr. Chang. "Instead of sitting on the surface of the eye, we implant that in the eye through a very tall, small incision and it sits securely inside the eye indefinitely."

As an animation from Visian shows, the cartridge is inserted into the opening and then the lens is unfolded inside the eye.

"The lens is placed behind the cornea and behind the pupil, the iris which is the colored part of the eye," says Dr. Chang. "While it's meant to be permanent, should a new procedure come down, 20 years down the line, or the lens needs to be removed for whatever reason, it can be done so."

After the 15 minute surgery, Rustia can already see. And a week later his vision is even better. He's back to work as a graphic designer and says his vision is remarkable.

"I'm doing day to day things, driving, driving at night and not using any eyeglasses or contacts and I'm getting along just great," says Rustia. "Now I don't have to be dependent on something else so it feels like my natural eyes basically. Things are great."

It's a new approach to 20/20 vision.

If you think you might be a candidate for this new lens implant, you can learn more about the procedure by reading below:

Physician profiled:

Steve Chang, M.D.
Director of Cornea and Cataract Surgery
Pacific Vision Institute
One Daniel Burnham Court
San Francisco, CA 94109
415-922-9500

Surgery performed at St. Mary's Hospital in San Francisco.

Background information:
The Implantable Contact Lens (ICL) is the newest addition to the array of procedures that offers patients with moderate to extreme nearsightedness (myopia) an option to improve their vision and eliminate their dependence on eyeglasses or contact lenses. This minimally invasive surgical procedure approved by the FDA, offers relief to patients who are not candidates for LASIK.

How:
Similar to a contact lens, the lens is manufactured to the specifications of the patient's vision needs and works with their natural eye to focus. These implants which resemble contact lenses are placed between the cornea and the iris or just behind the iris. ICL implantation differs from LASIK in that it does not remove or thin the cornea (or any other part of the eye) to achieve its optical effect.

  • Unlike LASIK, the ICL can be undone or removed and even replaced with a new power ICL if there is ever a change in prescription years later. The ICL can also be used in cases of thin corneas and high, even extreme nearsightedness where LASIK would remove too much corneal tissue to be compatible with long-term structural integrity of the eye.
  • The best candidates for an ICL are between the ages of 21 and 45, with moderate to severe myopia. It is best if the candidate has not had any previous ophthalmic surgery and does not have a history of ophthalmic disease such as glaucoma, iritis or diabetic retinopathy.
  • The ICL surgery is similar to that which is performed millions of times a year for cataract surgery.
  • The procedure is performed in an outpatient setting and, typically, one eye at a time is corrected. The recovery is very fast and dramatic vision improvement can be experienced within 24 hours after the procedure. Most patients return to their normal activities the next day.
  • Most patients achieve 20/20 or better vision, and virtually all have 20/40 or better after the procedure. It is particularly effective for patients with moderate to severe myopia (nearsightedness) and is recommended for patients who experience Dry Eye.

    Dr. Steve Chang, director of Cornea and Cataract Surgery at Pacific Vision Institute in San Francisco is among the first to perform this surgical procedure in San Francisco.

    About the Visian ICL
    STAAR? Surgical Company's Visian ICL - "ICL" stands for Implantable Collamer Lens also called the Implantable Contact Lens. It is made out of a collagen copolymer. Collagen is the same naturally occurring substance present in all of our connective tissue and the eye. It is highly biocompatible and not recognized as a foreign object as a result of its unique makeup.

    Unlike LASIK or PRK, the Visian ICL implantation does not permanently change the shape of the eye. The lens is folded and introduced into the eye through a small opening. After it unfolds it is tucked under the iris of the eye. And although essentially permanent, it may be removed or replace if the prescription or future technology makes it appropriate. It has been implanted in over 60,000 eyes worldwide. Over 99 percent of patients in the clinical trial were satisfied with their vision after the Visian ICL procedure.

    Website: www.visianinfo.com

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