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- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: December 12, 2024
At Blue Fin Vision®, our prestigious Harley Street eye clinic in London, we understand that patients considering Implantable Collamer Lens (ICL) surgery often have questions about potential complications. One concern that frequently arises is the possibility of developing glaucoma after ICL surgery. In this comprehensive guide, we’ll explore the relationship between ICL surgery and glaucoma, providing you with the information you need to make an informed decision about your eye health.
Understanding ICL Surgery and Glaucoma
What is ICL Surgery?
ICL surgery is an advanced vision correction procedure that involves implanting a specially designed lens into the eye to correct refractive errors, particularly high myopia (severe short-sightedness). Unlike laser eye surgery, ICL preserves the natural lens of the eye and can be an excellent option for those who are not suitable candidates for procedures like LASIK.
What is Glaucoma?
Glaucoma is a group of eye conditions characterised by damage to the optic nerve, often associated with elevated intraocular pressure (IOP). If left untreated, glaucoma can lead to progressive vision loss and even blindness.
The Link Between ICL Surgery and Glaucoma
While ICL surgery is generally safe and effective, it’s important to understand that there is a slight increased risk of developing glaucoma following the procedure. However, it’s crucial to note that this risk is relatively low for most patients.
Incidence of Glaucoma After ICL Surgery
Research has shown that the risk of developing glaucoma after ICL surgery is approximately 0.1-3.2% within the first two years following the procedure. This represents a small but significant increase compared to the general population.
Causes of Glaucoma After ICL Surgery
Several factors can contribute to an increased risk of glaucoma following ICL surgery:
- Steroid-Induced Ocular Hypertension
One of the most common causes of elevated IOP after ICL surgery is a steroid response. Steroid eye drops are typically prescribed after surgery to reduce inflammation, but in some individuals, these drops can cause a temporary increase in eye pressure.
- Retained Viscoelastic Material
During ICL surgery, a gel-like substance called viscoelastic is used to protect the eye’s internal structures. If not completely removed at the end of the procedure, this material can block the eye’s natural drainage system, leading to increased IOP.
- Pupillary Block
In rare cases, the ICL can cause a blockage of the normal flow of fluid between the back and front portions of the eye, leading to a sudden increase in IOP. This is more common with older ICL models and is less likely with newer designs that incorporate a central hole for fluid circulation.
- Excessive Vault
If the ICL is too large for the eye or is positioned incorrectly, it can cause excessive “vault” or space between the lens and the eye’s natural lens. This can lead to angle-closure glaucoma by pushing the iris forward and blocking the drainage angle of the eye.
- Pigment Dispersion
The ICL’s position in the eye can sometimes cause it to rub against the back of the iris, releasing pigment particles. These particles can clog the eye’s drainage system, potentially leading to pigmentary glaucoma.
Symptoms of Glaucoma After ICL Surgery
It’s crucial for patients who have undergone ICL surgery to be aware of the symptoms of glaucoma. These may include:
- Gradual loss of peripheral vision
- Blurred vision
- Eye pain or discomfort
- Headaches
- Seeing halos around lights
- Redness of the eye
In some cases, especially in the early stages, glaucoma may not present any noticeable symptoms. This is why regular follow-up appointments with your eye care professional are essential.
Prevention and Management of Glaucoma After ICL Surgery
At Blue Fin Vision®, our expert ophthalmologists take several steps to minimise the risk of glaucoma and ensure the best possible outcomes for our ICL surgery patients:
- Comprehensive Pre-operative Assessment
We conduct thorough eye examinations to identify any pre-existing risk factors for glaucoma. This includes measuring the anterior chamber depth, assessing the drainage angle of the eye, and evaluating overall eye health.
- Advanced Surgical Techniques
Our skilled surgeons use the latest techniques and technologies to ensure precise ICL sizing and positioning, minimising the risk of complications.
- Careful Post-operative Monitoring
We provide close follow-up care to detect any early signs of elevated IOP or other complications. This typically includes:
- Regular IOP measurements
- Slit-lamp examinations to assess ICL positioning and vault
- Anterior segment OCT scans to precisely measure the vault and anterior chamber angle
- Patient Education
We ensure our patients are well-informed about the signs and symptoms of glaucoma and the importance of prompt reporting of any visual changes.
Treatment for Glaucoma After ICL Surgery
If glaucoma does develop after ICL surgery, prompt treatment is essential to prevent permanent vision loss. At Blue Fin Vision®, we offer a range of treatment options:
Medical Management
- Topical Eye Drops: These are often the first line of treatment and work by either reducing the production of fluid in the eye or increasing its outflow.
- Oral Medications: In some cases, oral carbonic anhydrase inhibitors may be prescribed to further reduce eye pressure.
Laser Treatments
- Selective Laser Trabeculoplasty (SLT): This procedure uses laser energy to improve the drainage of fluid from the eye.
- Laser Iridotomy: In cases of pupillary block, a small opening can be created in the iris to allow for better fluid circulation.
Surgical Interventions
- Trabeculectomy: This traditional glaucoma surgery creates a new drainage channel for the eye.
- Drainage Implant Surgery: A small tube is inserted into the eye to help drain excess fluid.
- Minimally Invasive Glaucoma Surgery (MIGS): These newer procedures offer a less invasive approach to improving eye drainage.
In some cases, removal or repositioning of the ICL may be necessary if it’s determined to be the primary cause of the elevated IOP.
Long-term Management and Follow-up
Patients who have undergone ICL surgery require long-term follow-up to monitor for any signs of glaucoma development. At Blue Fin Vision®, we recommend:
- Annual comprehensive eye exams
- Regular IOP checks
- Periodic visual field tests to assess for any changes in peripheral vision
- Optical coherence tomography (OCT) scans to monitor the health of the optic nerve
Why Choose Blue Fin Vision® for Your ICL Surgery?
At Blue Fin Vision®, our Harley Street eye clinic in London offers:
- Expert Surgeons: Our team of highly skilled ophthalmologists specialise in ICL surgery and glaucoma management.
- State-of-the-Art Technology: We use the latest diagnostic and surgical equipment to ensure the best possible outcomes.
- Comprehensive Care: From pre-operative assessment to long-term follow-up, we provide complete care throughout your journey.
- Personalised Approach: We tailor our treatment plans to each patient’s individual needs and risk factors.
- Patient Education: We believe in empowering our patients with knowledge about their eye health and potential risks.
Conclusion
While ICL surgery can slightly increase the risk of developing glaucoma, it’s important to remember that the overall risk remains low for most patients. The benefits of ICL surgery in improving vision and quality of life often far outweigh the potential risks for suitable candidates.
At Blue Fin Vision®, we’re committed to providing the highest standard of care for our ICL surgery patients. By combining expert surgical skills, advanced technology, and comprehensive patient education, we strive to minimise risks and achieve the best possible outcomes.
If you’re considering ICL surgery or have concerns about your eye health after undergoing the procedure, we invite you to schedule a consultation at our London eye clinic. Let us help you navigate your options and provide the expert care your eyes deserve.
Remember, your vision is precious. Trust Blue Fin Vision® to provide exceptional care, combining cutting-edge expertise with a compassionate, patient-centred approach.
