ICL after LASIK

Recover your eyesight with ICL after LASIK

• Why does vision decrease after LASIK?

  1. age

  LASIK peaked in 2008 with about 400,000 people undergoing surgery annually, but is now reduced to about one-tenth of that.
  Those who underwent surgery in the early 20s at the time may have diminished vision due to age-related progression of myopia.

  2. Preoperative refraction

  It is generally said that the progression of myopia slows down after the age of 30 and stops around the age of 40. However, it is known that myopia progresses even after the age of 40 with high myopia, and those who had high myopia before surgery may have decreased visual acuity due to the progress of myopia.

  3. Limitations of treatment to scrape the cornea

  LASIK is a treatment that corrects myopia by scraping the cornea with an excimer laser to flatten the curve of the cornea. Since human has the function of repairing all the wounds, the cornea also has a reaction to restore it by the repair function of the living tissue.
  As a result, the improved eyesight becomes myopia again and the eyesight deteriorates. Therefore, the stronger myopia and the more the cornea is shaved, the stronger this tendency is, and the more easily the eyesight deteriorates.

• How about LASIK re-surgery?

  1. Can anyone have LASIK re-surgery? How to operate?

  In LASIK, the above-mentioned factors reduce eyesight, but if the cornea is thick enough and there is no abnormality in the shape of the cornea, the reoperation is fine.
  When re-surgery, instead of making a new flap, the flap of the first surgery is opened with a special instrument and irradiated with a laser. This flap can be opened more than 10 years after the first surgery.
  In other words, LASIK flaps have not completely adhered and healed even after more than 10 years.

  2. Problems with LASIK reoperation

  1 ) A space is required for the corneal thickness
  If you have a lot of cornea scraped with high myopia before the first surgery, or if the cornea is thin before the surgery, there are some who cannot afford to scrape the cornea further in the re-surgery and cannot perform the re-surgery. However, such individuals can recover their eyesight with additional ICL surgery.
  On the other hand, with ICL, even if the eyesight deteriorates, unlike LASIK, everyone can recover their eyesight by exchanging the power of ICL.

  2 ) Invasion of corneal epithelial cells under the flap
  In LASIK re-surgery, the first flap is opened and the laser is radiated and then restored. If you are over 40 years old, the wound heals slowly, or if you create a thin flap during the first surgery with high myopia. Postoperatively, there may be complications of corneal epithelial cells getting under the flap (epithelial invasion).
  As epithelial invasion progresses, the cornea becomes cloudy, resulting in vision loss due to astigmatism and a foreign body sensation.
  In such cases, it is necessary to open the flap again to remove the invading epithelial cells.

  3 ) Re-vision loss
  People with LASIK and poor eyesight tend to have poor eyesight after re-surgery.
  In this case, if the cornea is thick enough, the eyesight can be restored by the second re-surgery, but it is very rare to have the third surgery.

  4 ) Appearance and deterioration of dry eye
  In LASIK re-surgery, the flaps are opened during the first surgery, so the sensory nerves of the cornea are cut and dry eye occurs temporarily, just like during the first surgery.
  Many people improve over time as they did during the first surgery, but those with strong dry eye before surgery may get worse after re-surgery.

  5 ) Increased halo glare
  In LASIK, scraping the cornea increases higher-order aberrations, so many people find it difficult to see the night light such as halo and glare after surgery.
  However, this phenomenon becomes thinner with time and becomes accustomed to it, but it cannot be helped, and it is necessary to wear sunglasses and special polarized glasses, and to instill miosis to prevent the pupil from widening at night. Some people do.
  In the re-surgery, the cornea is further scraped, so the halo and glare are temporarily increased again.

  6 ) Kerato-ectasia
  Since LASIK scrapes and thins the cornea, it may cause a complication called kerato-ectasia (iatrogenic corneal ectatics), which is rare after surgery.
  Kerato-ectasia is also called postoperative keratoconus because the lower part of the cornea protrudes and has a shape similar to keratoconus. In this case, irregular astigmatism reduces corrected vision, so even if you wear glasses or contact lenses, it will not look like it was before surgery.
  Treatment of kerato-ectasia is to suppress progression by corneal cross-linking, which is the same as keratoconus, and to improve malformation by intrastromal ring, but it is not possible to regain the good naked-eye vision as after LASIK. (Click here for a detailed explanation of keratoconus)

• Is it true that ICL (intraocular contact lens) is harder to lose eyesight than LASIK?

  

  1. In ICL, correction with a lens with power

  Unlike LASIK, ICL is an operation to correct myopia with a power lens (like glasses or contact lenses), while LASIK cures myopia by reshape the cornea.
  Because the refractive power of the lens does not change in the eye, vision will not decrease like LASIK, and unless myopia worsens, vision will not decrease.

  2. With ICL, the effect is same for all people

  Because LASIK is effective by scraping the cornea, even if the degree of myopia is the same, the correction effect will differ depending on the individual, depending on whether the laser is effective or not.
  On the other hand, ICL corrects with the power of the lens, so if the person has the same myopia power, the correction effect is exactly the same.

  3. Less myopia to correct in additional ICL surgery after LASIK

  Even if your eyesight is reduced due to LASIK, it does not return to the original power before surgery, and the reduced myopia is a little mild myopia.
  With ICL, even with mild myopia, you can obtain as good naked-eye vision as with eyeglasses and contact lenses.

  4. Less surgical invasion with small incision in ICL

  LASIK makes a flap with a diameter of about 9 mm and irradiates the cornea with a laser, but with ICL, you only need to insert the lens from the wound of 3 mm.
  Therefore, there is little invasion to tissues and stable visual acuity recovery can be obtained from the early postoperative period.

• Reasons why people with LASIK and poor eyesight prefer ICL

  • 1. The focus of refractive surgery shifts from LASIK to ICL
  • 2. Why LASIK and vision-impaired people prefer ICL instead of LASIK re-surgery
    When asked why they want ICL surgery instead of LASIK re-surgery for those who have poor eyesight due to LASIK, many people give the following reasons.
    • 
      1 ) Because of the low vision after LASIK surgery
      2 ) I'm worried that my eyesight may get bad even if I have LASIK surgery again.
      3 ) I don't want to scrape the cornea anymore
      4 ) I was told that I couldn't re-operate because I couldn't afford to scrape the cornea anymore.
      5 ) ICL is a more reliable and safer operation
      6 ) ICL can be restored by removing it

• Points in ICL surgery after LASIK

  １. Do you need pre-LASIK data?

  Since ICL surgery determines the lens power based on the current myopia power that has decreased after LASIK surgery, the myopia power and corneal thickness data before LASIK surgery are not required.
  Anyone who has LASIK at any facility can have ICL surgery.

  ２. Visual acuity test and power determination are important

  After LASIK, the autorefractometer (measurement of myopia and astigmatism with an instrument) and manifest refraction are likely to be different from those before LASIK surgery, so it is important to have an orthoptist who is familiar with refraction and refractive surgery test the visual acuity.

  ３. It is possible that eyesight has already deteriorated due to kerato-ectasia

  Keratoconus treatment is required for keratoconus (mentioned above) rather than just vision loss. After treatment with kerato-ectasia, it is possible to get even a slight improvement in vision by undergoing further ICL surgery.

  ４. In the case of age-related lens hardening (nuclear cataract)

  If you are 50 years old or older after LASIK, your eyesight may be impaired due to myopia due to nuclear cataract (nuclear myopia). In that case, cataract surgery can improve eyesight instead of LASIK re-surgery or ICL surgery.

  ５. Post-LASIK ICL postoperative results depend on the skills of the orthoptist and the surgeon

  Postoperative results of ICL after LASIK depend on preoperative examination, frequency determination, and surgical technique, so a wealth of knowledge and surgical experience related to refractive surgery is required.
  At our hospital, experienced orthoptists and surgeons are in charge of surgery, and many people with LASIK and poor eyesight have improved with ICL surgery and have acquired good naked eye vision. The results are shown below.

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