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January 17, 2007

U-M Kellogg Eye Center goes beyond LASIK with new vision-correction procedure

ANN ARBOR, MI – If you're not a candidate for LASIK eye surgery, don't give up hope. The University of Michigan’s Kellogg Eye Center is now one of just a handful of eye centers in Michigan offering a new vision-correction procedure that can help you shed your glasses or contact lenses.

The procedure involves implantable lenses, called phakic intraocular lenses or IOLs, that are surgically inserted into the eye. Once in place, the lenses provide significant improvement in the quality of a patient’s vision.

Kellogg surgeons are using the new Visian Implantable Collamer Lens (ICL), which is the most recent phakic IOL to gain approval from the U.S. Food and Drug Administration. The Visian ICL has been proven to be effective in patients with a wide range of myopia, or nearsightedness, anywhere from -3.0 to -20.0. Before this procedure became available, this degree of myopia could not be corrected with any other type of surgical procedure.

To date, more than 55,000 people worldwide have had the Visian ICL implanted. Candidates for the procedure are patients who suffer from myopia and typically are between the ages of 21 and 45. This surgery, however, may still be an option for those over the age of 45. The ideal candidate has not undergone any ophthalmic surgery and does not have a history of eye disease. 

"This is a great procedure for all those people who have not proven to be good candidates for LASIK surgery," says Shahzad I. Mian, M.D., corneal and refractive surgeon at Kellogg. "Typically, these patients have had to wear thick lenses to correct very high degrees of myopia. Now we can offer them an alternative with potential for excellent quality of vision."

The surgery is very similar to cataract surgery, which is the most commonly performed eye surgery in the United States. The big difference, however, is that the Visian ICL does not replace the eye's natural lens, but instead is placed behind the iris (the colored part of the eye).

The incision required to implant the Visian ICL is small and is located at the far edge of the cornea. After the lens is in place, sutures typically are not necessary to close the incision. And, because this procedure does not require any structural alteration of the cornea or lens, complications are reduced and results tend to be stable and predictable.

Mary Ruppenthal, 47, of Ypsilanti, had been thinking about vision correction for years. But because she was severely nearsighted, she was not a good candidate for LASIK surgery. When she learned that IOLs had been approved by the FDA, she consulted with Dr. Mian and, in the summer of 2006, scheduled surgery for both eyes. Ruppenthal says the results have been amazing.

“Once the lens was in place, I could see so clearly right away. My recovery has been great and my vision is crystal clear," she says. She notes that on a recent trip to Aruba she could swim and snorkel without worrying about contacts or glasses. Although the surgery is expensive, she says it's been worth every penny. “I was so nearsighted that my glasses were running $500 to $600 per pair. The surgery has been worth it," she says. 

In addition to correcting high degrees of myopia, phakic IOLs offer several other advantages. First, it may work well for patients who are not candidates for LASIK due to corneal irregularity or thinness. Also, this procedure is less likely to cause or contribute to dry eyes. Lastly, the surgery is completely reversible.

A typical procedure takes 15-30 minutes and is done on an outpatient basis. Most patients report they are comfortable throughout the surgery due to the use of topical anesthetic drops and the option of taking a light sedative. Patients do not feel the lens once it has been implanted, and the lens does not require maintenance.

As with most surgeries, there are risks. Since a lens is being placed inside the eye, there is a potential for damage to the eye's natural lens, which may result in a cataract, or clouding of the lens. This clouding has occurred in less than 2 percent of patients. Other risks include complications from iridotomy (a procedure in which a laser is used to make small openings near the edge of the iris) and an increase in eye pressure.

For more information on phakic IOLs and all our other refractive surgery options, visit the Kellogg Web site at www.kellogg.umich.edu/LASIK.  To find out more, call 734-615-6914 or send e-mail to lasik@umich.edu.

Written by Aimee S. Bergquist, 734-763-4660,

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