ICL

ICL
Name	Implantable Collamer Lens
Alt	Phakic intraocular lens
Specialization	Ophthalmology
Synonyms	Phakic IOL, ICL

ICL

The implantable collamer lens is a type of phakic intraocular lens used to correct refractive errors. It is implanted into the posterior chamber to address myopia, hyperopia, and astigmatism when corneal procedures are unsuitable. The device and its associated procedures intersect with technologies, regulatory pathways, and clinical practices spanning multiple institutions and key figures in ophthalmology.

Introduction

The device is a biocompatible lens placed between the iris and the crystalline lens for refractive correction, often considered alongside alternatives such as laser-assisted in situ keratomileusis and photorefractive keratectomy. Patients are evaluated in clinics affiliated with institutions like Moorfields Eye Hospital, Bascom Palmer Eye Institute, and Wills Eye Hospital, where comparisons to procedures performed at centers such as Johns Hopkins Hospital and Mayo Clinic inform candidate selection. Regulatory approvals by agencies like the United States Food and Drug Administration and the European Medicines Agency influence availability in markets served by manufacturers headquartered near research hubs associated with universities such as Stanford University and University of California, San Francisco.

Medical Uses and Indications

Indications include moderate to high myopia, hyperopia, and astigmatism in patients with contraindications to corneal refractive surgery. Typical candidates are evaluated for anterior chamber depth, endothelial cell density, and crystalline lens clarity at centers like Massachusetts Eye and Ear Infirmary and Cleveland Clinic. The lens is considered for patients who have undergone procedures at institutions such as Lions Eye Institute or who are influenced by outcomes reported from trials led by investigators at University of Miami Miller School of Medicine and Columbia University Irving Medical Center. Contraindications parallel criteria set forth in guidance from regulatory bodies including the European Commission and professional societies like the American Academy of Ophthalmology.

Procedure and Technology

Surgical implantation is performed in ambulatory settings by surgeons trained in techniques used at referral centers like Wilmer Eye Institute and Singapore National Eye Centre. The procedure involves a small corneal incision, insertion using an injector system developed by manufacturers with research ties to institutions such as University of Utah, and central vaulting to avoid contact with the crystalline lens. Preoperative imaging modalities include anterior segment optical coherence tomography devices from companies collaborating with laboratories at Massachusetts Institute of Technology and ultrasound biomicroscopy protocols influenced by studies from University of Washington. Lens materials, often proprietary collamer compositions, were characterized in work associated with polymer science groups at University of Cambridge and Imperial College London.

Risks and Complications

Complications reported in clinical series from hospitals like Stanford Health Care and Toronto Western Hospital include cataract formation, increased intraocular pressure, endothelial cell loss, and lens rotation in toric models. Management strategies draw on practices established at institutions such as Great Ormond Street Hospital for pediatric considerations and adult protocols from New York Eye and Ear Infirmary of Mount Sinai. Surveillance regimens mirror postoperative pathways used in trials sponsored by consortia including those at University College London and Karolinska Institutet. Serious adverse events have prompted postmarket studies overseen by regulatory authorities including the Pharmaceuticals and Medical Devices Agency and committees convened by the World Health Organization for device safety assessments.

Outcomes and Long-term Care

Visual outcomes reported by multicenter studies from networks including European Society of Cataract and Refractive Surgeons and investigators at Duke University show stable refractive correction with high patient satisfaction compared with cohorts treated at centers like Bascom Palmer Eye Institute. Long-term care emphasizes monitoring of endothelial cell density, cataract progression, and vault measurements via imaging protocols used at University of California, Los Angeles and McGill University Health Centre. When cataract extraction becomes necessary, surgical strategies reference techniques refined at Rothschild Foundation Hospital and training curricula at specialist units such as Aravind Eye Hospital to manage lens exchange while preserving corneal health and intraocular pressure control.

History and Development

The evolution of phakic intraocular lenses traces through early intraocular implant pioneers associated with clinics like Wills Eye Hospital and research groups at University of Toronto. Development accelerated with contributions from engineering teams collaborating with ophthalmologists at Harvard Medical School and material scientists at ETH Zurich. Regulatory milestones include approvals in jurisdictions represented by agencies such as the Ministry of Health, Labour and Welfare (Japan) and the Therapeutic Goods Administration following clinical trials published by investigators at University of Melbourne and Seoul National University Hospital. Ongoing innovation continues in device design, injector systems, and imaging-guided planning influenced by cross-disciplinary collaborations at institutions like California Institute of Technology and National University of Singapore.

Category:Ophthalmology