Risks of Refractive Lens Exchange Surgery

No eye surgery is without risk. In eyes that have reasonably good sight, surgery should only be undertaken if the risk of significant loss of vision from the surgery is extremely remote.

Risks involved include:

  • Overcorrection or Undercorrection occurs if the prescriptive power of the implanted lens is too strong (overcorrected), or too weak (undercorrected). In most cases it can be corrected with corrective eyewear or with a lens replacement.
  • Post operative infection can occur during any surgery though severe infections during lens implantation is rare.
  • Post operative increased intraocular pressure. The sooner a surgeon is alerted to this complication, the greater the chance of avoiding serious damage.
  • Damage to the natural lens can occur. If the damage is severe, the natural lens may need to be replaced with an intraocular lens.
  • Cataract s will develop in over 50 percent of the population by the age of 65; however, there is the some risk that the ICL procedure may cause cataract s at an earlier age.
  • Retinal detachment may occur, It should be noted, however, that the occurrence of retinal detachment increases as the degree of myopia increases.
  • Halos, glare, and double vision; accommodating lenses and monofocal lenses significantly diminish this risk.
  • Vision loss is extremely rare. Typically the loss of visual acuity is due to bleeding, severe inflammation, or an untreated infection.
  • It is important to note that the majority of these risks are present in all refractive procedures, including LASIK and PRK .

Factors which affect the level of risk are:

  • Surgeon experience
    • Surgical technique
    • Minimal trauma to the inside of eye
    • Small self-sealing wounds
    • Superior antibacterial agents
  • Technical factors
    • Detection of eye problems preoperatively
    • Surgical instrumentation
    • Operating room sterility
  • Eye Factors
    • Specific eye diseases (like Macular Degeneration , Glaucoma , Corneal Disease such as Fuchs Dystrophy , Diabetic Retinopathy)
  • General Health
  • Patient Age

Over the last decade of cataract and lens exchange surgery (some 14,000 cases) our incidence of significant loss of vision is less than 0.1% or one in a thousand. Many of these patients have considerable general infirmity which limits their ability to heal and combat infection, and many have had significant disease or injury to the eye prior to having cataract surgery.

The risk for healthy patients with normal eyes is difficult to estimate, but certainly is much less than one in a thousand. In our practice over this past decade we are unaware of a single cataract patient with healthy eyes under the age of 70 who has had a significant loss of vision with this surgery*.

The ICL risks of vision loss and cataract development are rare. Improvements to implantable contact lens models have diminished the frequency of many ICL risks.

*loss of three or more lines of vision on Snellen chart.