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As with all refractive procedures, a comprehensive ocular examination is performed both to rule out any contraindications and to provide an accurate assessment of refractive error. During the slit lamp examination of the anterior segment, we pay particular attention to anything that could slow or hamper epithelial healing following the procedure. Any blepharitis or meibomian gland dysfunction should be treated prior to surgery. Even asymptomatic lid disease can cause significant symptoms post-operatively. Tear deficient and evaporative dry eye should be tested for with tear osmolarity (TearLab), Schirmer’s, and TBUT and treated appropriately and aggressively prior to surgery. Images to evaluate the patient’s anterior chamber depth and endothelial cell count is important to obtain before proceeding with surgery. Patients with too shallow of anterior chambers are at a greater risk of angle closure post-surgery.

Pre-op measurements:

  • Visual Acuity: with and without correction, distance and near

  • Manifest refraction

  • Cycloplegic refraction

  • Pupil size: photopic and scotopic

  • IOP

  • Slit lamp exam: Anterior and Posterior, with a dilated fundus exam

  • Endothelial cell count: examination for any guttata or endothelial irregularities

  • Oculus Pentacam

  • ORA: Ocular Response Analyzer

  • **See: Diagnostic Technology Advances Tab for the description of these instruments

During the pre-operative examination, it is important to not only get the appropriate measurements (Refraction, Topography, Corneal thickness, Wavefront, Cycloplegic refraction, and Tear film assessment), but is also an important time to set appropriate patient expectations and discuss the different types of ICL technologies.

We recommend liberal and unrestricted use of preservative-free artificial tears and nighttime gel or ointment. We will typically place inferior extended duration dissolvable collagen plugs and for those patients who have drier eyes prior to surgery, we will place inferior silicone and superior collagen plugs prior to surgery.



We use the Visian ICL (implantable collamer lens) at Vance Thompson Vision. The ICL is placed in the posterior chamber, behind the iris and does not require the natural lens to be removed. This procedure is recognized as an alternative to corneal refractive surgeries like LASIK.


The Verisyse ICL is a similar implantable lens, made of medical-grade polymethylmethacrylate, or PMMA. The Verisyse ICL is placed in the anterior chamber, in front or your iris. of the lens. Both lenses are FDA approved for the correction of nearsightedness.

Post Op

Follow-up Regimen: 1 Day, 1 Week, 1 Month, 3 Months, 6 Months, 1 Year.

1 Day Post-op:

Tests to Perform: visual acuity, slit lamp exam, IOP

The day following surgery, patients will continue to experience mild to moderate discomfort as the incision site from surgery. It is common for patients to have moderate foggy vision and photophobia due to mild anterior chamber reactions post surgery. The lens will be assessed for proper positioning within the eye and patients should be reassured on healing times. Due to the inflammation and positing of the lens, glare and halos are common after surgery and will continue to improve over the first 3-6 months post surgery and neuroadaptation to the new correction continues. We extensively educate patients on continued adherence to the post-surgery drop regimen. Patients will be on a combination: antibiotic and steroid drop; with appropriate lubricating drops for continued healing of the ocular surface.

Due to the intraocular surgery, there is a risk for post surgical IOP spikes after ICL placement. Patients may experience increased light sensitivity, significant headache, brow ache and/or nausea. In patients experiencing any of the above symptoms, they should be seen by one of our doctors right away to assess the IOP and possible treatment may be started.

1 Week Post-op:

Tests to Perform: Visual acuity, slit lamp exam, IOP

Visual acuity, photophobia and overall comfort will continue to improve. During the slit lamp evaluation, we are ensuring proper positioning between the iris and natural lens with the Visian lens, and proper stabilization of the lens to the iris with the Verisyse lens. Patients will continue their combination drops at this time.

1 Month Post-op:

Tests to Perform: Visual acuity, Refraction if not 20/20, Slit lamp exam, IOP, Endothelial cell count, anterior OCT

Patients will have all imaging related to the lens position and endothelial cell count redone to ensure proper healing from surgery. Most individuals will be able to stop the combination medications after week 2; a slit lamp evaluation will be performed to asses anterior and posterior segments.

3 Month Post-op:

Tests to Perform: Visual acuity, refraction (if considering enhancement), slit lamp exam, IOP

This is typically the earliest we will want to consider an enhancement. Although we would prefer to wait until the six month post-op exam. We also want to see a stable refraction before considering an enhancement. If we are considering an enhancement, then a cycloplegic exam, tear film, endothelial cell count, Anterior OCT: anterior chamber depth, corneal thickness and topography must also be performed. The doctor will then use the information to decide if LASIK or PRK is the best option for an enhancement.

6 Month Post-op:

Tests to Perform: visual acuity, refraction, slit lamp exam, IOP

If we are considering an enhancement, then a cycloplegic exam, corneal thickness, and topography must also be performed. We also want to a stable refraction at this point before considering an enhancement.

1 Year Post-op:

Tests to Perform: visual acuity, refraction, slit lamp exam, IOP