Implanting the lens in the eye (other eyesight correction methods)

What is the difference between intraocular lens implantation and laser vision correction?

These lenses are also called phakic intraocular lenses ( IOLs) because they are implanted on a natural lens (fakos = lens). They are an alternative to LASIK and PRK laser treatments for moderate to high shortsightedness (myopia), astigmatism correction, and in some cases provide better and more predictable results than laser corrections.

When are such lenses implanted instead of laser correction?

Lens insertion may be implanted in people under the age of 45 who have high refractive errors and are not candidates for laser surgery for a number of reasons (too thin corneas, dry eye, corneal abnormalities, etc.). Laser dioptre removal takes place on the cornea, i.e. on the surface of the eye, unlike the phakic lenses that are implanted in the eye on a natural lens.

Phakic IOL are transparent lenses that are surgically placed between the cornea and iris or immediately behind the iris without removing the natural eye lens. This gives the patient a natural accomodation for near distances, with both near and distance vision correction.

What is the difference between ordinary contact lenses and lenses that are implanted in the eye?

The implantation of a phakic IOL corrects the vision in a similar way to a conventional contact lens with the difference that the phakic IOL is implanted in the eye instead contact lens placement on the cornea. Therefore, they are also called implantable contact lenses (ICL). The second important difference is that after the implantation of the intraocular lens, the patient does not feel that there is something in the eye and there is no need to maintain such a lens.

Such a lens is easily removed if it is necessary to replace it, so the operation is reversible and is therefore ideal for patients who can not correct the refractive error in any other way.

What is the difference between ICL implantation for people under 45 and replacement of lens with multifocal lens in persons older than 45?

When the lens is replaced, the natural lens is removed from the eye and an artificial intraocular lens is inserted into it, while the ICL (intracameral lens) is implanted in front of the natural eye lens which remains in place.

What if I have a refractive error higher than -10 D or +5 D?

In this case, ICL may be an option for you, of course, provided that the eye configuration that is measured on a range of ultra-precise devices allows the implantation of such a lens.

Who is a good candidate for implantation of the ICL lenses?

Good candidate for ICL is a person under the age of 45 with high refractive error in which laser refractive surgery is contraindicated, and eye configuration allows the insertion of intracameral lenses.

What does the examination look like?

A complete ophthalmic examination (determination of visual acuity and refractive error, biomicroscopy, eye pressure measurement and ocular background examination) is performed as well as the measurement of the refractive power of the  intraocular lens to be implanted.
The exam lasts 30-60 minutes. Before most eye examinations, it is desirable for the patient to be without contact lenses for some time (how long – it is best to consult a physician). After the examination, the pupils are dilated for 1-2 hours, and depending on the refractive error, for some patients it will be harder to drive after the examination and it is recommended not to drive for several hours.

See more details about the examination

What does the implantation procedure looks like ?

The surgery is performed in so-called topical anesthesia (only eyedrops are used, no injections), the patient is conscious and cooperates with the surgeon during the entire procedure. Preoperative activities (eyedrops, disinfection of the surgical area, covering with sterile drapes) last for about 40-60 minutes. The next day the patient comes for a control exam and further check-up examinations are arranged with the doctor.

Before the surgery – Preparing for the procedure

Upon patient˙s arrival to the clinic, eye drops for pupil dilatation are applied. Blood and eye pressure are measured. Detailed slit-lamp examination is performed. After about an hour (depending on how fast pupils dilate), the patient is ready to go to the operating theatre.
Nurses disinfect the skin around the eyes, put a sterile drape over the patient, and place an eyelid holder that prevents patient˙s blinking. The eye is anesthetized with the eyedrops and there is no need for complete anesthesia. The injection is not given and the procedure is completely painless.

Course of the surgery – On a procedure day

The surgery itself lasts around 10 minutes. The patient looks at the light source and is constantly awake and communicating with the surgeon. Since surgery is painless and fast, most patients are surprised that everything has passed so quickly and easily, and that all the fears that people usually have before the procedure were unfounded. The surgery is performed through a small cut, only 2-3 mm wide, without the need for sutures or any kind of injection. At the end of the procedure, the surgeon implants the lens in the eye, which also enters the eye through the same small incision and unfolds in the eye in a predetermined position (the capsular bag). At the end of the surgery, the sterile eyepatch is put on the eye and the patient leaves the operating theatre with the help of the medical staff.

After the surgery – How long does it take to recover?

After the surgery, the eye drops and ointment are applied and the eye is covered with a sterile patch. If the surgeon decides that it is necessary – the patient gets an eye pressure-lowering pill (Diamox).

Right after surgery

Immediately after surgery, the eye is covered with a sterile patch which is usually removed the next day or after a few hours if the surgeon suggests so.

1-2 days after surgery

Visual quality and recovery depend on the severity of the procedure itself and is faster if the surgery is easier and less traumatizing for the patient’s eye. The next day, most patients see well without any aids.

One week after surgery

A week after the surgery, the quality of vision of the most of the patients reaches the final visual acuity that remains.

Month after surgery

After a month – vision is sharp. We do not expect any further changes or worsening of the distance vision. After 45 years of age, an additional plus reading diopter is needed.

What are the possible complications after the ICL implantation?

As with any other surgical procedure in medicine, complications may occur when implanting intracameral lenses.
These are : light phenomena such as glare, residual refractive error, secondary glaucoma, infection, inflammation, cataracts, retinal ablation. The frequency of most complications depends on the quality of preoperative examination and the surgeon’s experience.
In the Knezović Polyclinic we have performed this type of surgery for years and we use only the best quality lenses. To date, we have never had any complications after the implantation of the ICL lens in the eye.

Is it possible for the refractive error to reappear after the insertion of the lens?

It is of paramount importance that the refractive error is stable for at least one year. This is rarely the case in practice and most patients have a good eyesight for many years.

Is it possible to do the examination and the surgery of both eyes on the same day?

First you need to do a specialist examination at the Clinic, where all of your eye parameters are measured. The lens for each patient differs according to the parameters and is ordered directly from the manufacturer.
When the lens arrives (usually within 2 weeks) then the surgery is performed.
Second eye surgery is usually scheduled one month after the first one.

If you have additional questions and need a more professional answer to your problem please feel free to contact us!

Implantation of the intracameral lens (ICL) in the eye – How much does it cost and what does it look like?

What kind of lenses do we implant?

In our Clinic, we implant modern lenses of the world’s best manufacturers (Verisyse, Veriflex and Visian ICL). Because of the smallest amount of potential complications and the best results, most of our patients have Visian ICL lenses implanted.

Verisyse – a phakic intraocular lens

IOL Verisyse is a phakic intraocular lens that is positioned in front of the iris. It is used to correct shortsightedness of -5.00 up to -20.00 diopters. Verisyse is a lens made of special plastic material suitable for medical purposes (polymethylmethacrylate or PMMA). Generally, it is not visible in the eye after the implantation, although it can be seen in the more detailed close inspection (e.g. in the mirror).

Veriflex lens

is a phakic IOL that is made of flexible material which allows for smaller cut (incision) during the implantation and therefore faster recovery after surgery.

Visian ICL lens

is the ultimate lens made of patented Collamer material, fully biocompatible to the eye. The product is made by renowned Swiss company Staar Surgical.

Used for diopters:
• Shortsightedness of -1 D to -20 D
• Farsightedness from +1 D to +10 D
• Astigmatism up to 6 D

Advantages of Visian ICL Lenses:
• Superior UV protection
• Does not cause dry eye syndrome
• The procedure is reversible and can be combined with different surgeries in the future
• Large clinical experience – over 250,000 lenses implanted since 1997
• Fast postoperative recovery
• The lens is invisible in the eye and aesthetically is an ideal solution

The price of the procedure varies depending on the type of lens that best suits individually for the patient.
Check all current prices and deals in our price list.

Dr. Knezovic – Surgeon

Dr. Knezovic is an ophthalmic surgeon who had implanted an ICL lens among the first in Croatia. Results and Surgical Techniques were presented in 2015 at the annual congress of Croatian Ophthalmology Society.
Dr. Knezović has undergone special training and workshops for this type of surgery (London, Vienna, Munich) and is licensed to carry out these interventions. In addition to the ICL lenses with ordinary spherical refractive errors, Dr. Knezović has also been trained for the implantation of toric ICL lenses that deal with high refractive error and astigmatism in one act. To date, he has performed a large number of these operations and gained considerable experience in these precise surgical procedures.

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