3+ year update: narrowing vault/space in left eye :(
I went to see my Opthalmologist for my annual check up last week. 20/20 both eyes, which was great to hear, but unfortunately they told me the vault between my natural lens and my ICL on my left eye has narrowed. He said it's natural for the space to narrow as one ages, but that it is not a good thing obviously. However, there's still space -- so nothing to worry about. Just need to monitor annually. Not the greatest news, but nothing I can do right now to worry... Will provide another update next year. Hopefully it won't be worse!
Hi bionic man :)
ReplyDeleteI am happy to have found your blog since i am having similar issues with the iridotomy holes as you do (still not sure if this could not just be left out all together until you hit 50 or so).
Lens: Artiflex (6mm diameter or so. bigger version)
Besides the moving hair on my eyelashes (iridotomy problem) i also see trefoils and slight halos as you do.
A possible explanation for this in your case might actually be the pupil diameter in the dark! My pupil is huge in the dark and my doctor warned me, that the lens won't cover it at night, hence halos and trefoils.
There are drops you can use that last for an entire evening if you so need (long drive or cinema or whatever).
The more irritating thing is the iridotomy flares hopping around in my line of sight. I will definitely try the tatoo and go full color from the start after reading your experience.
The drops you can try to see if halos dissapear: Allergan Alphagan.
They contain Brimonidini tartras.
I tried them once sofar and night vision is as never before!
How it works: they are used to lower your eye pressure. Side effect is: pupil does not dilate fully anymore (just a bit less).
And exactly this "side effect" is the effect in our case.
I am curious to hear, if your pupil dilation is the reason for the halos.
What ICL model did you get?
I dont know how this works here, but my email is: luxirom@gmx.ch
Thanks for this comment, luxirom! You clearly know a lot more than me! For the halos -- I did mention that I experienced this before the ICLs. I had high astigmatism and just terrible eye sight to begin with and they did say that ICLs would not help the situation. For me, halos are a normal experience and I haven't really experienced life without them. As a result, they don't bother me and I haven't pursued the eyedrops.
DeleteAgain, I'm not a doctor and cannot provide medical advice, but given your stories, there doesn't seem to be a downside to at least trying out corneal tattoos. If they work for you, great! if they don't, then at least you tried. I tried, and they didn't work - they did offer to do it again, but I declined since I don't really notice the white lines as much as others do since my eye lids do cover them up unless I actively force my eyes open wider than they naturally sit.
I have Visian ICLs!
hello. I'm about to decide to do ICL surgery on my both eyes. (-5.5 and -6.5)
ReplyDeleteand I came across this blog when I was doing some more research on ICL
I'm really glad that you still keep this blog updated :)
I have few questions for you, hope you will read it some day.
Do you still recommend ICL after all these years? my doc said I'm suitable to do either Lasik or ICL since -6.5 is right in between. I'm still debating.
How's your eye pressure so far? I heard some people say it's giving them migraine from time to time.
Do you know about your endothelial cell count right now? I read a study that after this surgery you steadily loss your endothelium cell each year. This is really my main concern.
Anyway, I'm going to have my eyes checked by another doc on Monday. Best wishes to you. If you would like to, shoot me an email on
ken21personal@gmail.com
Hi Ken: based on my personal experience and stories that I have heard, it does seem like LASIK is the better way to go if that is an option for you.
DeleteMy eye pressure has been fine every check up for the last 3 years. No migraines. I don't know what the cell count is, but the main concern is really:
- post iridotomy white line glare that many people experience (see rest of my blog)
- risk of cataract development
These are pretty big things to consider and I would recommend reading through my blog - esp the comments sections, as those have been fertile grounds for many people's personal stories. I hope it helps and that you make the decision that's right for you. Many people in my family have done LASIK and the only negative side effect i've heard from them is dry eyes...
Thank you very much for your reply. I have just put a down payment for my doctor to order both the ICL lenses(with centre-hole). Crossing my finger now and hope nothing goes wrong with my eyes in 30+ years!
Deletereally wish i see your comment little bit earlier tho!
Sorry, things have been super busy and I don't get to check this regularly. At least you got the latest and the greatest ICL with the center-hole! That's the one I wanted, but 3 years ago, it was only available in Europe. This means you won't have to go through any of the iridotomy issues that everyone else seems to be experiencing so that's a bonus! It's probably worth asking your doctor to see if you can switch your downpayment to LASIK instead...:) Good luck either way!
DeleteI want to reply to the Unknown friend above. But I cannot. I really want to know where he or she got the center-hole lens. If anyone knows or the Unknown friend sees my reply, could you please contact me? My email is ktzhao1022@gmail.com. Thank you very much!
DeleteHello Katie and Unknown,
DeleteI'm planning to get ICL done next week with Vision EVO lenses (with the centre-hole). How were your experiences?
Thank you!
Hi there,
ReplyDeleteI had ICLs in both eyes about 7 years ago. Reading your blog was like reading my own experience - sans the corneal tattoos, haven't had those done yet, but thought about them over the years. I was very happy, overall, with my surgery, even despite the halos and glare and iridotomy side effects, but, that was not to last. This year went in for an eye exam, and got diagnosed with cataracts in both eyes. They gave me about a year, after that both my natural lens and the ICLs will have to come out. Apparently nowadays it's been established that ICLs cause cataracts... I wish I had known it back then. Just something to keep in mind for anyone considering this procedure.
Andrew
Andrew: that is terrible. They're taking our your natural lens too? What happens next? Back to glasses? What surgeries or results will you expect?
DeleteAndrew: I just came across this article: http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/newest-icls-associated-low-incidence-cataract-formation
DeleteI have the Visian ICLs implanted just a few years ago. Perhaps you had the older Phakic IOLs which seem to be causing cataracts? Either way, I sincerely wish you the best with your eyes going forward -- whatever it is you may need to go through. I hope you share the results with us too!
Nope, I had Visian ICL too (by Staar Surgical). They were implanted by one of the top doctors in the US too, and the surgeries went smoothly.
DeleteThe way it was explained to me recently by my current doctor (who participated in FDA study of ICLs), is that at one point in time they had great hopes for the ICLs, they were supposed to be the future. But nowadays the theory goes that they interfere with the flow of intraocular fluid that washes over the natural lens, and that lack of proper flow is what leads to the cataract formation. As for what's next - if I do nothing, I will go blind within a year. Thankfully cataracts is a very common surgery these days, but yes, both ICLs and my natural lenses will have to come out. I had to go ahead and pick out my next set of implantable lenses. After researching all options ad nauseum, I have decided to go with Acrusof IQ monofocal lenses, set for distant vision, and will depend on glasses for near vision for the rest of my life. I have also researched multifocals, and adaptable IOLs, but it seems that the glare problems with those are even worse than with ICLs, so I'm opting for monofocals, as they seem to provide the best overall optics with the least amount of side-effects.
One upside of getting monofocal IOLs is that supposedly they provide better optics than even the natural lens does, so I might be able to see the world a little brighter and crisper, and the colors more vivid, if only at a distance. Wish there was a solution that replaced the function of the natural lens completely, but unfortunately, right now, there isn't one.
As for the supposedly low incidence rate of cataracts post ICLs - at the time of the surgery I was also told the chance of cataracts was small, and I might be dealing with cataract issues when I'm 65 or 70 (i just turned 34, btw). So maybe I'm just unlucky, who knows, but the doctor I saw recently seemed knowledgeable about this issue and essentially said that was the reason ICLs never took off. So it's hard to say who to believe, also, from what I've read in the past, a lot of those studies looked at incidences 1 year post surgery, and 3 years post surgery... well, I didn't have any problems at those points either.
DeleteAndrew, do you know which lens you had? The V4B, V4C, or V5?
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DeleteI am not sure how to determine that, it is not listed anywhere on my lens cards, which you can see below:
Deletehttps://www.dropbox.com/s/cta8gul58605152/staarvisian-web.jpg?dl=0
Thanks, Andrew.
DeleteDo you know what your (dilated) pupil size is?
Also, if you wanted to would you be able to get contacts or glasses after removing the ICL or do you have to get another lens?
I'm not sure about my pupil size. I was never given that info. As for another lens, since with cataract my own natural lenses have to come out - I'll need replacement IOLs to be able to see. If I didn't have cataracts, then yes, ICLs could've come out, and I could go back to wearing -11 glasses or contacts.
DeleteHi Andrew, a recent Swiss study shows 40% cataract rate for phakic IOLs at 5 years, 55% at 10 years. So many people with IOLs are going to have an experience like yours eventually.
ReplyDelete(It's possible the newest IOLs like the Visian with Centraflow will be better, but data is not yet in.)
That's true. Who knows. One discouraging sign is that our annual Ophthalmologist follow-ups focus quite heavily on looking to see if cataract formation is starting or not... I guess early discovery of signs could lead to the possibility of removing the ICL before it's too late?
DeleteThis comment has been removed by the author.
DeleteI guess one other question is whether one wants to electively and pre-emptively remove one's ICLs in case cataracts form...but that is putting the cart before the horse after spending all this money and grief getting them in the first place (not to mention the iridotomy problems being a permanent remaining issue). Hmm...
DeleteI asked my doctor specifically if removing my Visian ICLs now would at least stop the progression of my cataracts - the answer was "no, once the cataract starts it will progress on its own".
DeleteAnonymous, do you have a link to that study? I'd like to look over it.
DeleteThanks
https://market-scope.com/breaking-post/phakic-iol-patients-at-risk-for-cataracts-elevated-iop-within-10-years-study-shows/
Deletehttp://archopht.jamanetwork.com/article.aspx?articleid=2498860
That Swiss study needs to be read in context.
DeleteThey measured icls from 1999 (these would have been the oldest icl models and icls have absolutely been developed in that time).
They don't mention the age of the patients (many studies have now shown that people over the age of 40 are more likely to develop cataracts than those under).
They don't mention vault space at implantation(this is absolutely key in determining the likelihood of getting a cataract) and whether these patients had enough space at implantation.
Further, it doesn't mention surgeon skill and technique. Icls need to be placed well and gently.
There are cataract risks with icls. But frightening people against them with no balanced arguments is redundant. As high myope, we are more likely to get cataracts anyway.
Icls give options to the highly myopic. Peer reviewed journals have rated them safe and effective consistently.
It's sad that some people have gone through issues with them but what is needed is a balanced view of this procedure, not scaremongering.
"It's sad that some people have gone through issues with them but what is needed is a balanced view of this procedure, not scaremongering."
DeleteI don't think us sharing our stories is "scaremongering", if anything, a more balanced approach is needed, to show that it's not all sunshine and roses with ICLs.
Hello there, I had ICL done a month ago, I'm generally happy, my distant visión is good, but my near visión is terrible, something I wasn't warned about.
ReplyDeleteI have to wear reading glasse, I was wondering, did you notice changes in your near visión? For reading books etc...?
i had clear vision all around... so I would definitely ask your doctor what the reason is and how it can be addressed. Sometimes it takes your brain a while to adjust, but after a month you should be well on your way... my doctor warned me that perfect vision is not guaranteed (and therefore reading glasses might be necessary) since the distance between the ICL and your natural lens is an imperfect estimate in terms of getting your ICL prescription accurate... a few months later my optometrist did say she recommended reading glasses since my vision was 20/30 in one eye and 20/20 in the other...but it wasn't strong enough for me to get glasses. And after a year, my brain adjusted and i have been 20/20 in both eyes ever since. Definitely get more answers from your doctor if you can!
DeleteHi there,
ReplyDeleteThanks for this information. So with all of these problems going on with the visian icl , do you sincerely think is worth having this surgery done? I wasn't a candidate for lasik or visian icl, my doctor told me to wait for the Visian Toric but hasn't been approved yet in Usa, I was going to go to get in another country but now my doctor wants me to check again with the corneal specialist to see what they can do for me here in the usa so I don't have to travel overseas for the toric icl. I am very nervous and afraid and after reading these posts not sure if I can go ahead with this. Any recommendation would be great.
Johanna
Hi joucita: i can't recommend anything one way or another -- it's really up to you and a licensed doctor's advice. Given all the risks you've read about - and how risk averse you are personally - i'm sure you will come to a decision on your own. Take time to think about it. I considered the risks for over a year before I went for it. I'm certainly scared of the risk of cataract development, but it's something that is a risk for elderly people anyway (though much higher risk for ICL folks of early onset cataracts). I decided to take the risk as life without glasses was that important to me. I'm happy with the results right now, but that feeling might change quickly if I develop cataracts. I can't live in fear and it's too late for me -- i will just have to deal with it if it happens (it's not blindness after all, though still traumatic and life affecting still). Again, do the research, consider the risks, speak with your doctor and take all the time you feel you need before coming to a decision :)
DeleteI think destiny put me across your blog just on time. Blessings for you.
ReplyDeleteThat's what this blog was meant for. Take care and all the best!
DeleteThank you for making this blog! I also think destiny put me across your blog just on time. I was just about to go through with implanting ICL in my eyes and did one final search before the operation and ended up on your blog.
ReplyDeleteEveryone considering ICL should read this article and the study itself before making a decision:
https://market-scope.com/breaking-post/phakic-iol-patients-at-risk-for-cataracts-elevated-iop-within-10-years-study-shows/
http://archopht.jamanetwork.com/article.aspx?articleid=2498860
Remember that ICL is a relatively new procedure and that data of longtime side effects are just starting to come in.
For me, as this article shows, the risk of developing cataract is way to big to accept. I honestly cant justify it to myself to take this big a risk just to get rid of glasses and contacts. I personally will wait until more long time studies get published or other techniques get available.
Thank you again for making this blog, I think you saved me from future suffering. Sometimes the internet can be a blessing! :)
No one is ever immune from "future suffering".
DeleteSuch hyperbole! Icls have been shown to be safe and effective. Of course there are risks, but they way you put it, you'd think everyone is going to get cataracts within a week.
There are plenty of happy iclers out there! Their stories are just as valid as those who sadly didn't have as easy as time.
Thank you so much for your blog.
ReplyDeleteI did the iridotomies and am now stuck with TERRIBLE "white line" glare. I regret ever considering this surgery. Unfortunately, it seems corneal tattooing will be my only way out.
What did your tattoo look like? (do you have any pictures?) I've seen some pictures and they don't seem to look very nice... I'm not sure what to do anymore.
Are your tattoos still there as of today?
It's not the only "way out". I had HORRIBLE side effects from the original iridotomies that were done by another doctor (not the one who later did my surgeries). Not only did I have white lines, but I actually had triple vision in one eye. Because the 2 iridotomy holes were so wide, they acted like tiny secondary pupils. Needless to say this was a shocking experience, to see 2 ghostly copies of everything, everywhere I looked. I ended up going to a specialist eye surgeon who performed a 6 hour suturing operation on my iris, suturing shut both of those iridotomies.
DeleteNow, I have to say that staring for 6 hours into a bright light while having to remain completely motionless as the surgeon worked to close the tiny holes was one of the most uncomfortable things I ever had to experience. The actual ICL surgeries after that felt like a joke by comparison. I felt like I could finally relax when they started the normal ICL procedure. But anyway, while not pleasant, be aware that this is another option for those suffering from bad iridotomy side effects.
You can see below the photo of my eye before and after iridotomy suturing:
https://www.dropbox.com/s/ygch9iogo9ttxvt/Iridotomies-OS_pre%26post_suture.jpg?dl=0
Hi to both of you! Andrew that sounds like a terrible experience! Suturing anything...let alone your eye! AH! How are you now? I definitely haven't heard of such an extreme result such as yours...double vision. YIKES.
DeleteTo the previous poster, I don't have a photo of my corneal tattoo because my eyes are brown/black and you cannot see the tattoo at all unless you're an optometrist or ophthalmologist. I don't see or feel them -- and I also rarely notice my white lines, but as you've probably read in the rest of my blog, I have smaller eyes and the lids, when in resting position, basically cover my iridotomies... but when I open my eyes really wide, forcefully, I can see them.
All the best to you both. Definitely try tattooing before suturing if that's an option for you!
I am fine, whatever side effects I have left from iridotomies now are minor and I'm ok with them for the most part. Once my ICLs come out, I do plan to find a doc to try corneal tattoos. But very few doctors have heard of ICLs, let alone corneal tattoos, so we're all navigating murky waters here.
DeleteWow Andrew that is scary! I was told that suturing an iridotomy was incredibly risky and nearly impossible, and unfortunately very expensive (I was quotes 9000+!)
DeleteHow much did it cost you?
So you're removing your ICL and then planning to do a corneal tattoo? Did the suture not completely eliminate the glare? :(
My glare is pretty bad, but at least I don't have triple vision -- that sounds absolutely awful. I'm so sorry you had to go through with that. Unfortunately, the glare is affecting my work and mental state so I'll have to do something about it.
I would agree that it is a complex procedure, because the holes so incredibly tiny. Even though I still have some lines after suturing, everything was SO much better after surgery. I am not entirely sure about the cost of the stand alone iris suturing, as my costs were rolled into my main ICL procedure, which cost me 11,500 (that was 7 years ago though). I believe my doctor also filmed the iris suturing for some conference presentation, so I may have been a guinea pig more or less at the time, and therefore was not charged as much as I might otherwise have been.
DeleteI've read about some people reporting good results with corneal tattoos. But - in the mean time you can also try contacts that reduce pupil size. I remember seeing those and even ordering some years ago, but I never liked wearing contacts so they didn't take for me. I just got used to my lines over the years.
Why are you getting your ICLs out now Andrew? Are you having issues with them?
DeleteMy doctor says he can do corneal tattooing for me for free, but I'd be his first patient for that... which makes me a little wary.
I do eliminate the glare by placing my fingers across the holes, so hopefully corneal tattooing would be a good solution for me.
Sigh, this year has been so stressful and I just want this over with ASAP x_x
I dunno if I'd trust someone to do a first time surgery on me... not on my eyes anyway. Wish I knew of a doc who did many corneal tattoos, I wouldn't even mind traveling to see one.
DeleteAs for why ICLs are coming out, like I posted earlier in this thread, got diagnosed with cataracts in both eyes, so that's that. Got 7 years of use out of the ICLs. In retrospect I should've stuck with glasses/contacts, but I got soooo tired of them. Wanted that freedom. Oh well.
Yeah... that's how I feel. My mom wants me to do the tattoo with him, but I think it's because we already put in a 1000 deposit for ICL that is unrefundable...
DeleteHe's a very skilled LASIK surgeon (he did my mom's LASIK many years ago) so that's probably another reason why my mom trusts him.
But I just don't know. I've been so stressed out over this and I want it over with, but that's how I got into this situation in the first place.
And I'm sorry to hear that. I wanted that freedom as well, but I suppose I should've appreciated what I had. This year has been such terrible to me and I just want everything to go back to what it was a year ago x_x
Thank you so much for chatting with me. It's hard to get other peoples' experiences on this ordela so it's nice to hear from you :)
No problem, it's good to hear from other people who have gone through the same thing. BTW, for what its worth, with all the "fun" iridotomy side effects, there's actually a positive one too - we can't develop angle-closure glaucoma anymore (a major cause of blindness). For what it's worth, I suppose that's at least one less thing to worry about in later years.
DeleteHah, yeah I suppose.Though I probably wouldn't be at risk for glaucoma for quite some time anyhow :P
DeleteMy glare seems to be worse this week. It's annoying how much it fluctuates.
I really need to decide on what to do. Hopefully, I can get the tattoo before the holidays but I still have to decide whether I want to do it with my doctor or travel to another doctor and do it x_x
One thing I want to mention is that getting a corneal tattoo now might make it difficult (if not impossible) to do iridotomy suturing later (should you decide to pursue that route). But that's something to ask your doctor about. I'd also still suggest trying colored contacts first (black or brown) to at least see if there's any change in the visibility of your lines. They might also help your doc to know how far the tattoo needs to extend (if you find that the contacts do indeed help).
Deletehttp://www.healio.com/ophthalmology/retina-vitreous/news/print/ocular-surgery-news/%7Bfe5c9d17-8686-4a90-b0ec-eba5b1120b2f%7D/man-presents-with-visual-complaints-after-laser-peripheral-iridotomy-in-left-eye
Oof, that would suck. Unfortunately, I'm not sure I have the mental fortitude to handle suturing... nor do I have the money :x Not to mention the possibility of having to tattoo anyway afterwards.
DeleteMy main concern at the moment with the tattoo is finding the correct doctor and how "big"/noticeable the tattoo would be. Kind of a silly concern but yeah :/
My vision also seems to be getting worse. Over the last year I think my astigmatism went up a little and my myopia went up by ~.25 My eyes seem healthy for now, but with my prescription being -9.75 and -10.75, I'm worried about how my eyes will be 10 years from now. Retinal detachments sound so scary.
If only we had good genes :(
Andrew, do you mind telling me who your surgeon was?
Deleteif you leave me a way to contact you, i can send you the name of my doctor -- keeping in mind the fact that i don't know how experienced he is doing corneal tattoos (he said he's done them before me), the tattoo didn't work (he offered a second round to darken the tattoo, but i declined) and that i feel in retrospect he could have warned me better about the white lines in the first place...
DeleteMy surgeon was Dr. Jack Singer from Randolph, Vermont. Unfortunately he passed away not long after my surgery. I would be interested to know of any doctors who have performed corneal tattoos, for future reference.
DeleteSure, what would be the best way to leave contact information but not publicly?
DeleteIf you would please email me at infmis@gmail.com, thank you!
DeleteSorry for the delay. Just sent you the info!
DeleteWow, that sucks that your iridotomies still cause minor white lines even though your lids cover the holes.
ReplyDeleteFor me, my eyes open pretty wide so the holes cause really bad glare, its also why I'm worried about the tattoo after seeing pictures, but maybe they can see the tattoo because of the picture's lighting. (it also looked quite large). I'm also worried about the tattoo being done wrong since my doctor has NEVER done it before, so I'm not sure I want to be the first patient.
My glare does get eliminated when I cover the holes with my fingers, so hopefully a tattoo would eliminate the issue for me.
As for ICL, I'm probably going to not do it... ever. As much as I would love to be glassesless (esp with my awful -10.5 -9.5 vision), I've learned to appreciate what I had before...
It's a personal choice. I still don't regret getting ICLs (yet... now just waiting and hoping cataracts won't be a thing for me), but I fully understand why you wouldn't. Personally, if I was a candidate for LASIK, I would have gone for that instead. Too bad I wasn't!
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ReplyDeleteDid anyone ever find anything that worked to get rid of the white lines glare? I'm having issues with that and several other things from just the laser iridotomy alone. I'm terrified this will all become permanent. I had the iridotomy a week and a half ago. I'm in Colorado and haven't been able to find anyone who does the tattooing here.
ReplyDeleteIt may be worth it to travel to another city to try the tattooing. I haven't heard of another solution :(
Delete