Investigating eye surgery and ICL. The pros and cons of different procedures.

By Joseph Jones
Issue 92 - March 2010

It was at university that I first started to guess that my eyesight might be deteriorating. One particularly hungover morning, hunched blearily in a back row of the lecture hall, the words on the projector screen seemed to blur together. I put it down to the after-effects of the night before, but it happened again and again.

When I started working, my distance vision gradually worsened as staring at a monitor for hours on end took its toll. Eventually, I bowed to the inevitable and purchased my first pair of glasses. They had Rayban designer frames, but they were glasses all the same.

While I was delighted to be able to see, I found from the start that wearing glasses changed people’s perceptions of me. I was told I looked more studious; I noticed a more positive reaction from people when I wasn’t wearing them. At job interviews or on nights out, I’d slip the glasses into a pocket. Contact lenses were duly bought but never used; I found them very uncomfortable.

Despite this, I never even considered surgery. The thought of lasers or scalpels being aimed at my eyes just seemed plain bad sense. At Pacific Healthcare’s offices, it was therefore with surprise that I found myself being so quickly convinced of the benefits of letting someone cut a hole in my eye and slide a small lens beneath the surface.

I was encouraged by the testimony of two people who had undergone the surgery, and the fact that Dr Cheryl Lee talked me through the procedure step-by-step. Even so, my preliminary appointment to check that I was an appropriate patient for the surgery was daunting enough. For the ultrasound, I stared upwards at what looked like a small goldfish bowl being lowered onto my eyeball. The local anaesthetic, however, made it a completely painless procedure. The video of the ultrasound is a fascinating blueprint of the eye as it continually twitches and moves within the socket. It’s also crucially important for Dr Lee, enabling her to accurately gauge the space between cornea and lens, to determine if there is sufficient space to insert the synthetic lens. 

Video footage of the ultrasound scan of my eyeball

Being myopic and with my left eye considerably weaker than the right, I was pronounced the perfect candidate for the procedure. The final stage is an appointment with an optician to get a detailed prescription and then to undergo the surgery.

Does perfect vision and a lifetime free of spectacles await me?

What is myopia?
Myopia or nearsightedness is where the eye cannot focus effectively on distant objects. The most common cause is that the eyeball is too long. The light does not focus on the retina at the back of the eye, but instead falls short, causing images to appear blurred.

What is ICL?
It’s an implantable contact lens. A small incision is made in the eye and the ICL is placed inside, between the iris and your eye’s natural lens. The ICL is made of the same material as the cornea of the eye, so the body will not reject it. It works like a contact lens, refocusing the light on your retina correctly.

Why use ICL?
For Deborah Lee, who had an ICL operation in December 2009, the two biggest differences are the convenience – she no longer needs glasses or contacts – and the fact that colours seem much more vivid post-operation. Deborah has experienced no side effects or irritation from the surgery.

Since the ICL is closer to the natural lens of your eye, it’s much more accurate than glasses or contact lenses. It’s also unlikely to be dislodged by physical activity. As with any operation, there are some risks, but less so than with other forms of eye surgery.

What are some other options?
Obviously, you can continue to wear glasses or contact lenses. Refractive surgery is the most common alternative surgery. This is where the cornea, the transparent shell over the iris and lens, is shaved down to ensure that light hits the retina. This will achieve much the same results as an ICL procedure, but does have a number of drawbacks. 

Pascal Aeschlimann, who had both lasik (laser) surgery and later an ICL implant, says that the biggest difference between the two was that lasik affected his night vision, with “halos” appearing around light sources – something that the ICL corrected. The most common complication, though, is dry eyes, as the surgery can affect the ducts that keep the eyes moisturised, leaving them dry and irritable.

What will an ICL operation cost?
Costs differ slightly depending on the lens you require, but an ICL operation for both eyes is around $6,000.


Pacific Healthcare Eye, Cataract and Retinal Specialist Centre
290 Orchard Road
#19-01 Paragon
+65 6883 6961