Saturday, December 09, 2006

My ICL Eye Surgery Experience, Part I

I recently got a relatively new eye surgery called ICL or IOL surgery performed on my left eye. I wanted to share my experience with others via my blog in case there's someone out there who's considering the procedure. ICL basically puts a contact lens inside your eyeball. It's a new option for people with terrible nearsightedness (like myself) who are not good candidates for Lasik (like myself). However, it is a bit more involved than Lasik because it's a surgery. Also, like any surgery, results vary and there are risks. It might really turn out great, or it might cause an eye infection or a cataract. Anyone who is considering this needs to do their homework. Please keep in mind that this is just my own personal experience. Your situation and your results may be very different.

For almost twenty years, I've been very nearsighted. My left eye was -12.5 diopters before the surgery and my right eye is -11. I have always been dependent on glasses or contacts, but lately I've become frustrated with both. With my glasses, even the thinnest lenses were still very thick and the area of perfect vision through the lenses was very small. The glasses gave me headaches, slipped down my nose, and scratched up easily. My contacts frequently dried out, blurred, or fell out. I got dust and dirt caught behind my contacts, and my eyes itched a lot. I preferred contacts anyway because they gave me perfect vision and good peripheral vision, while my glasses did not.

When I heard about the ICL procedure several years ago, it hadn't been FDA approved yet, but I liked the idea of putting the contacts inside my eyes. Then I could have good vision without the constant hassle and irritation.

FDA approval of the procedure occured last year. The ICL surgery is expensive (about $10K) and is almost never covered by insurance, so it is way out of the budget for most people and it certainly isn't something you can just get done on a whim. I talked to my eye doctor about it and he agreed to send me to a center in Houston (I live near Austin) to see if I was a good candidate. Scheduling the entire procedure was a bit difficult. The surgery requires lots of doctor appointments, like so:
  • First visit - tests and more tests to make sure you are eligible
  • Second visit - YAG iridotomy, which puts tiny holes in the iris. The contact lens (ICL) will block the normal flow of liquid in the eye, which could raise pressure in the eye and cause glaucoma. These holes in the iris provide an alternative route for liquid to ooze around, preventing pressure buildup. You must get an eye pressure check one hour after the YAG.
  • Third visit - Surgery to put a lens in the first eye. Must be one week after the YAG iridotomy. A few hours after surgery you must go back for a pressure check.
  • Fourth visit - A post-op check to make sure everything looks good. The day after the surgery.
  • Fifth visit - A one-week post-op check to make sure the eye is healing up.
  • Sixth visit - Surgery to put a lens in the second eye. Must be about two weeks after the first surgery. A few hours after surgery you must go back for a pressure check.
  • Seventh visit - A post-op check to make sure everything looks good. The day after the surgery.
  • Eighth visit - A one-week post-op check to make sure the eye is healing up.
  • More visits - as needed or determined by the doctor
Since Houston is three hours away, I needed to work with the Houston center and my Austin-based eye doctor to figure out when I would be in Houston and when I could go to my regular eye doctor. It was complicated! I had to set up two overnight stays in Houston at a hotel. I also had to find someone to come with me to Houston because I was not allowed to drive after the tests (they dilated my eyes) or the surgery (due to sedation and blurry vision).

Some people may wonder what a YAG iridotomy feels like. Let me tell you, so far that has been the absolute worst part. First, the doctor puts drops in your eyes to contract your irises. This gave me a horrible migraine and I had to take several aspirin. Then they numb your eyes with more drops. Then you sit in front of this machine and they put a circular lens coated with gel into your eye, aim a laser through it, and pull the trigger to ZAP your iris. The zap is very unpleasant and the doctor has to carefully zap each iris about six times - two holes, three zaps per hole. It was surprising, a bit painful, and caused me to flinch each time the laser zapped. If you have ever had laser hair removal on your body, then I would say this was very similar, except inside your eye and without the burning hair smell. The leftover gel was truly a major hassle since you aren't allowed to rub it out of your stinging eyes. I had to dab at my eyes for hours and hours as the gel slowly made its way out. I was squinty and my eyes felt sandy and irritated for days afterwards.

The surgery a week later was a piece of cake, though I had to fast overnight so I was pretty hungry. I went to the surgery center, waited for several hours in an icy cold, totally packed waiting room, then got called in to a bed. They stabbed an IV in me, got me hooked up to some crazy machines, put a star in black marker over my left eye, poured drops in my eye, and made me lay there for a while. Because I was cold and hungry and a bit stressed out, I was shaking a lot. When they wheeled me into the operating room, the anesthesiologist started the drugs flowing to get me to stop shaking, and it really pretty much knocked me out instantly. I vaguely remember any of the operation, though I remember a nurse telling me I needed to wake up and put on my shoes because it was time to go home. I went back to the hotel and slept for several hours.

My eye felt just fine, though. After I woke up, and over the next couple days, my eye felt like normal, and I could even see out of it almost as well as if I had a contact in my eye (which I guess I did). It's been three days since the operation and my eye feels just fine. It's a bit blurry because the surgery causes temporary astigmatism and some swelling, but the doctor said that should go away in a few days. My vision is getting better every day. I have to put lots of drops in it throughout the day and I wear an eye shield in bed. I'm not allowed to bend over, pick up heavy things, go jogging, or do anything that might put pressure on my eye or jolt it. The worst part, though, was that I couldn't wash my hair or face for two days after the surgery! Bleah!

I'm wearing a contact in my right eye so I can function. The difference is noticeable, though. My right eye gets itchy and irritated by the end of the day, but my left eye is happy as a clam. On the other hand, my left eye's vision is somewhat blurry, so I am depending on my right eye to confirm what my left eye can only suspect. I am hoping that the difference between the two eyes will narrow somewhat as my left eye heals up and the astigmatism goes away.

In three weeks I will post Part II, which will be after the surgery on my right eye. We'll see how my left eye turned out and what I can expect from both eyes in the end. Will I still need glasses or contacts or have I finally been set free?

Edit 11/27/09: I've posted a three-year update about the ICL here: ICL Surgery Update: I have glasses

30 comments:

Deb said...

Hi, I read your entire ICL experience (both parts) with interest - I'm glad you had such a positive experience. I had ICL surgery in my right eye nearly 2 weeks ago and am getting a little nervous because I cannot see as clearly as I could with a contact lense or glasses. How long did it take for your left eye to clear? My vision is 20/25 in that eye now, but it is a very blurry 20/25, and the eye technician was unable to improve upon it during my exam a couple days ago. The doctor said there may still be some swelling, but most of the cases I've heard about had clarity in just a couple of days. Thank you for any insight you can share :) Deb M

happypitbull said...

Hi Deb M,

It took only about a day for me to see clearly, but my vision did waver a bit for the next several weeks before settling down. I also had a lot of trouble with halos at first, which causes blurry patches, but I've gotten used to that, for the most part.

Also, my left eye, which was the weaker eye, never quite made it to 20/20; it is still just a tiny bit nearsighted. But the right eye compensates for it just fine.

I should add that I can't see as well now as I could with contacts/glasses. I was surprised to learn that 20/20 vision was actually a step down from what I was getting with my contacts (I could see like a hawk wearing those, I swear), so now I can only see as well as a "normal" person. Sometimes I tell my husband, with alarm, that I can't see such-and-so, and he looks at me like I'm crazy and says, "Honey, nobody can see that."

Good luck! Jennifer

Nancy said...

Jennifer,
I had ICL about 5 weeks ago and am dealing with the halos. They're worse than before surgery, and are bad enough to make driving at night nearly impossible. I was wondering if you've noticed any improvement in your halos since your surgery.

My doc gave me a prescription drop to use before I have to drive at night and it does work to eliminate the halos, but I'm hoping I won't have to use it forever.

Otherwise, my vision, during the day, is 20/20. I was -12 prior to surgery.
And I agree about the YAG--it sucks! It was like getting popped in the eye with a rubberband, over and over.

happypitbull said...

Nancy,
The halos can be caused by a misplaced hole in the iris (from the YAG iridotomy). Correctly placed holes need to be high, so your eyelids will cover them. A misplaced hole is low enough that your eyelid doesn't normally cover it; so, light seeps in and it acts as a second pupil, muddling the image that hits your retina. This is why squinting can clear up the halo; your eyelid comes down and blocks light from entering the tiny hole.

Halos caused by this generally don't get better unless the hole closes up somewhat, and that's rather unusual--and undesirable, since the holes keep the pressure in your eye stable.

My halos haven't gotten better, but I've gotten used to them. I have learned to compensate somewhat. I squint, or turn on more lights, or re-orient myself so the light bounces off objects differently.

Anonymous said...

I am considering ICL surgery and have talked with several patients who have raved about the procedure. I am still a little nervous, would you recommend?

Thanks,

Juan

Jedimaster5577 said...

Gosh, yeah the YAG iridotomy was as you described for me. Boy that one sucked because of those drops that close the iris.

Tomorrow is my surgery and I pray that all goes well. Nonetheless, going into it have become a little pestered. To fix my astigmatism, I had my a corneal flap created last Thursday. This has caused a bit of haze in my vision, which I hope it clears up as they say because it is rather annoying.

Anyway, I hope all goes well. Seems it is more of a process than this instant gratification the eye centers sell it as. I hope that the recovery time is quick, for work sake and my sanity sake.

Thanks for the articles. Btw, need to update your 'progress' for all of us inquisitive folks. God bless.

Jedimaster5577 said...

Btw, 'Jedi' is also 'Rody'

Mike said...

Hi, I read about your experience, and I also had ICL surgery last year in august, so it's been almost 1 year for me. Before the procedure, my scrip was -8.5 in both eyes. I went to a Doctor in Long Beach, CA, who is supposed to be one of the top 3 doctors in California that do this procedure.

My experience was a bit different, as I had both eyes done at the same time. While the YAG part was a bit uncomfortable, I wouldn't say it was really painful for me. Maybe my doctor did something different, but the best I could describe the process was a feeling of some pressure, and then an achy feeling when he hit the zapper. A little uncomfortable, but not painful. But maybe my doctor uses some different drops. I didn't feel any burning or pinching or anything like that.

Also, he performed the surgery on both eyes on the same day. The entire process was maybe about 40 minutes once they rolled me into the surgery room. Immediately afterward, I could already see much, much better, though everything was still blurry. the next day, I had 20/20 in the left eye, and 20/25 in the right. A month later, I had 20/15 in the left and 20/20 in the right.

After 6 months, I had 20/15 in BOTH eyes. My one year checkup shows the same results. So it could take up to 6 months or so for everything to really settle in. I never had any kind of halos or vision abnormalities either. To say the least, I have been extremely happy with my results.

PRADEEP said...

is your life is normal after the surgery. can u lift heavy weights?, can u rub u eyes? what are the after effects of the surgery.

Alex said...

I'm getting one of my eyes done in a couple of days and the other in about 3 weeks. I'd also like to know about the lifting heavy weights question. I'm into weightlifting so if I can't do that I'm going to be disappointed. Probably should have found out before deciding to go ahead with this.

happypitbull said...

Pradeep and Alex--
My understanding is that once your eyes heal up completely, you can go on with your life as normal, which would include lifting weights, rubbing your eyes, and so on. (You just have to be careful while the incision is healing.)

It's been years since my surgery, and I have been given no special instructions or conditions at all. The only thing I have is a special card that I'm supposed to carry (I don't, heh) in case I'm in some sort of accident and am not conscious--the card lets doctors know that there are lenses in my eyes and they are *supposed* to be there.

But, check with your eye surgeon or doctor just to be sure this is true for you.

Alex said...

Thanks for the reply.
Got one eye done today, they had to do it twice because I had too much pressure in my eye after the first attempt. The bad thing was they didn't give me the sedation drug for the second attempt so I was freaking plus they were waiting for 20 minutes for a tool to be sterilized while I stared into that light. The eye was really scratchy before but seems to be settling down. I'm praying it all turns out ok.

Erin said...

Hi! I had my second eye surgery done yesterday (in Atlanta) & LOVE it! To answer a recent question to PRADEEP... yes, you can lift & pretty quickly. The day of & the first day after surgery, you're not to bend over or lift anything. The 2nd day after my first surgery, I was back in the gym. No problems, no pressure.
I thought the surgery was wonderful. Doctor's been putting lenses in eyes for years... lasik is too new & the ill side effects are truly not known past 20 years. Plus if the FDA comes up with something in 15 years, I'll just have it taken out without any irreversible damage to my eye!

I was fortunate to have the YAG done with my ICL implantation; therefore, I was under the wonderful anesthesia. There are a few doctor's who will do it that way - all you have to do is ask. He explained to me that the YAG procedure is so fine-tuned, there truly is no reason to perform the YAG the day before.

The worst part of the entire thing is that my doctor wouldn't do both eyes on the same day... however, I believe that is something that is coming around. I chose a dr. in Rome, GA... so there has been quite a bit of driving for us between the surgeries & follow-ups.

The cost was reasonable, approx $5K. The outcome has been outstanding! I went from a -15 to reading a 20/20 line in my left eye. I'm going for a follow-up today on my right eye, but suspect I'll read 20/20 as well!

To anyone who is considering having this done, do your research. There are a lot of people out who had problems with the drops, the YAG & halos... but I think that even within 2 year's, the surgery has come a long way!

Find a doctor who will do the YAG on the same day as the ICL procedure! Also, shop prices if you can! In Atlanta alone, doctor's ranged from $2K apart. A lot of doctor's also charged extra for follow-ups & the ultra-sound you have prior to the procedure. Good luck!

Alex said...

Erin
I'm glad you're happy with the outcome. I had one eye done on Monday, was pretty pleased with my vision the next day but since then it hasn't improved, and it isn't as good as when I wore contacts or glasses. Its just not as sharp.

Was there any significant improvement in your vision after a few weeks?

I have my next surgery in a little over 2 weeks so I'm thinking of not going ahead with it if my right eye doesn't improve. I'd much rather wear contacts and see properly and deal with a bit of dry eye rather than pay the rest of the fee (3.5k) and have to wear glasses or contacts anyway.

christina said...

hi deb
several years ago, i had a corneal ulcer that left a scar which prohibits me from getting lasic. the doctore i consulted with is supposed to be one of the top lasic docs in nyc, but has only done 35 icl operations. should i be concerned

-fellow pit lover

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av said...

Hi,

I agree, this is an excellent Blog. I just got my YAG done yesterday at the Herzig Eye Instt in Toronto. Certainly quite freaked out by the whole experience esp with the 6-8 shot of laser in each eye. Its been about 20 hours since the procedure and I'm still very worried about the side effects. I can see a few deflections as though I'm wearing a cracked lens and it feels that I have an eye lash in my eye.

Is this normal?

Abhi

Richard Gregory said...

Hi. I just has LPIs done today (13 shots in each eye) and had no problems. http://iclexperience.wordpress.com/2010/05/04/laser-peripheral-iridotomy-lpi/ has more info, for those that want the details.

A lot of what I've read about, from those who do have problems, goes away. Hopefully that has been your experience. :)

Cheech said...

I had ICL surgery in my left eye about five weeks ago but I have been having a few problems, the first of which are some rather large "floaters" - which can happen to people like me who are very near-sighted following the YAG iridotomy. But my biggest problem is that I can feel the lens moving inside my eye. The lens always does the same movement - drops a bit and then drops again. My doctor told me that he didn't see any movement of the lense, but I'm going to ask him to check again. Due to the constant movement of the lens, my eye feels very tired by the end of the day and recently the tiredness has begun to turn into a bit of pain. Due to these problems, I’ve decided not have ICL surgery in my right eye. I'm looking forward to hearing from anyone who has had any of these problems.

kaveh said...

hi guys
thanks to everybody here sharing his/her experiance with ICL. so listen to this, i'll be thankful of any advice you folks give:
i had surgery, both eyes at the same time. right eye was -8.5 with 3.25 astigma and left was -9 with 3.00 astigma.
after 5 days, i have a clear vision with my right eye but today i checked out optometery and it was -3 and 5.00 astigma for the left eye!
guys, it's obvious that i cannot see with my left eye, is this normal? why my right eye is so ferfect but left eye is more astigmatism than before surgery?!

Nike said...

I had ICL surgery in my left eye six days ago and will be having my right eye done tomorrow. My distance vision in my left eye is really good, but my vision close up is still quite blurry, although I feel it's definitely getting better. I did have some discomfort, a bit like wearing a scratchy contact lens and the eye felt "heavy", but there has been a marked improvement in the last couple of days. I just hope my close up vision still improves. Incidentally, I had the Iridectomy on the same day as the lens insertion under general anaesthetic, so know nothing about it! Will let you know how I get on.

Sanna said...

Hello ! I had my ICL on my left for 5 weeks ago and my right for 10 days ago.I've been very nearsighted. My left eye was -16.0 diopters before the surgery and my right eye is -12.with astgmatism about 1.20 on both. I dont have any kind of problem with halos but I have blurry vision, I supposed cos I still have astgmatism but even more than before 1,70. I thought this ICL would reduce my astgmatism to. It is not only the astigmatism on both eyes but Iam stll nearsighted on my left eye close to -3 diopters and I dont know if its normal??? The thing that worries me is that when he asked me with wich eye I would like to start with I said With the Left one pls . So after the procedure they informed me that I will have to wait a month for my Right Eye cos they have order by mistake 2 left Icl for me wich was -16. They told me they are sorry and that this has never happened before. So I waited 5 weeks for my Right one the -13. I keep on thinking if the have put the Right on the Left... this has make me crazy ... I read that the asigmatism can be better after 6 month I really hope so . About the YAG yeeehhh it was painfull. My Doc told me that it is more easy to put the holes on light colored eyes than on dark as I have . I will wait 6 months and hope to have a better vision without glasses !

Cheech said...

Sana - After my first surgery - in my left eye - I decided not to do my right eye. I'm very glad that I didn't! After about a month my left eye (with the ICL) was becoming very tired and dried-out feeling by the end of the day BUT there was nothing I could do about because it felt like that on the INSIDE. I am having my ICL removed in about a month. It will have been in my eye for about six months. I would've had it out a long time ago but my doctor kept stalling me because he couldn't see anything wrong with it. (So he says, anyway.) My right eye - with a normal contact in it - feels fine by the end of the day, ironically. Because I had the JAG done in both eyes, I have now have terrible "floaters" in each eye, which won't go away for years. I guess I just wasnt' lucky but I wish you all the luck in the world!

FTV6-CLASH said...

I had my surgery on Oct 28 2011.

Just want to pass this on to other people

I'm only 5 days out of post op (both eyes done same day) and I'm 20/20 is both eyes, I had light astigmatisms in both eyes (the toric ICL is not yet available in the U.S. so these lens DO NOT FIX astigmatism)
my left eye is still bit blurry if I close my right, I was still able to make out most of the 20/20 line, and doc said it should clear up more as i heal.

I have had no pain post op, my eyes where itchy for 1-2 hours after surgery.
I notice if i don't drink water my eyes feel dry, so i drink more water and they are fine.

1. The scary yag. it felt like a 9 volt on your tongue to me. some of the laser hits i felt and some i did not. I wasn't that bad.

The worse part of the YAG for me was the eye drops they gave me to constrict the pupils; gave me the worse headache of my life - ever. once the yag was done the headache went away within and hour.

2. before surgery they put this goopy gel in my eye to num it,(alone with dilation drops every 5 minutes) holly crap that stuff burns!! it was worse then the dentist!
however it only last MAYBE 30 seconds, then it was over.

4. surgery i felt nothing

5. I couldn't see crap after surgery, my left eye was dilated and my right was constricted. I was able to watch movies that nighte - headache from constriction drops again on right side, not nearly as bad this time.

6. went back after 2 hours for pressure check, 10 in one and 19 in the other

7. day 1, my left eye seemed in focus but had a milky coating to it, was worried about this, right eye still contricted, could see a little more.

day2
9AM was my follow up, Doc said left eye was swollin much more and just needed time

I took ibprofin (and my leg cramp i had lol) for the swelling and by that night the milky part was gone but was blurry.

the trouble here was my right was constricted and i needed that eye to see, but it was dim so in areas of low light i could not see hardly at all.

DAY3- left eye is catching the right fast, right eye still fully constricted. left got better all day.

by bed time the left could read as well as the right, right still constricted.

day4 - (tuedasy) back to work, follow up with doc, results above, right eye still slightly constricted. follow up in 2 weeks


day5 - right eye constrict nearly gone, left eye slowly progressing.

i have halos in my night vision BUT, i have had glasses since 2nd grade and contact since 6th grade. I have always seen halos and star-bursts. Honestly i thought everyone saw things that way until about 2 years ago LOL (i'm 27 BTW)

so to me the night vision has improved as the halos are NOT bothersome at all. the hollow are wrose on yellow, and street lights, brake and headlights are not bad at all.

also much better depth perception and contrast in my vision :)

CVMV said...

I had the ICL surgery done in both eyes. Let me just tell you all I was given was Valium and I was awake the entire time. It was the scariest moment of my life and I even have had natural child birth. I do not think this is a surgery that should be performed in an office without an iv. I dealt with high pressure 8 hours after the surgery and had to have my yag redone. I truly wish I did not get this surgery. I had extra Fsa money and I have been so nearsighted (-10) for so long. Now I'm dealing with halos and I'm actually exhausted by the end of the day having had my eyes opened all day. Truly do your research and ask for sedation. And be prepared it's a solid 20 minutes per eye.

Kimberly said...

Thank you all for all the blogs. I had my iridotomies 3 weeks ago and am scheduled to have my first eye done next Tuesday November 29th and the left eye the following week December 6th. I have to admit with all the reaserch I did I was quite nervous about the whole thing. The iridotomy procedure itself was not that bad for me but after the numbing drops wore off my eyes were quite uncomfortable for the day but pretty much back to normal the next. I am very excited for the surgery and hopefully be free of glasses and contacts which I have had since 3rd grade. I will send an update once my surgeries are completed to let you all know how I am doing.

Chris said...

I had ICL surgery over 2 months ago. Please be careful! I would never recommend this anymore. I had high pressure the night of the surgery in one eye... worked on it all that day and finally had to have a second surgery to reduce the pressure. My eye had permanent iris damage. I have had 4 surgeries in that one eye.

Now, my other eye is continually bothering me with an ACHE and a blurry spot that comes and goes. Have any of you ever experienced that?? The doctor says the ICL looks good, but this ache was never there before. I am at my end here. I'm doing warm compresses and eye massages as perscibed, but not much success.

This has been a horrible life-changing experience. If I could go back, I would.

Mansi said...

Chris, did you have any complications before you had this surgery? Is it contraindicated in some cases?

I'm considering having it done. I've had corrective lenses since second grade, so I'd like to finally be without them now (at 30).

Anshuman said...

Guys I got Torric ICL done on my right eye yesterday in India and am having a very blurred and dull vision since then. After reading the comments that close to normal vision is gained in about a day I'm getting skeptical. Can anyone tell me if this is normal?

Olivia NYC said...

Dear Mike,

Thanks for sharing your experience. Which doctor did your surgery?

Thanks
Olivia