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Many do not mind that it costs thrice that of a Lasik procedure as it gives better results for those with high myopia and has fewer side effects. POON CHIAN HUI reports
While the time-tested Lasik surgery is still popular here, more people who desire perfect vision are now opting for implantable contact lenses, eye specialists have observed.
In Singapore, about 1,000 such lens implants have been done since 2005, with 300 of the procedures performed this year alone so far, according to figures from STAAR Surgical Company, which produces the lenses used here.
Contact lens implants were introduced here in 2005 while Lasik – which does not use implants but involves cutting into the cornea and using laser energy to reshape it – has been available for more than 15 years.
It takes about 10 minutes to perform an implant – the same time needed for a Lasik procedure.
In general, implants can treat much higher degrees of myopia of up to 1,900 degrees per eye, while Lasik is usually limited to a maximum of 1,200 to 1,400 degrees. Hence, implants are especially suitable for those with high myopia of above 700 degrees in each eye. More importantly, people with high myopia tend to have thin corneas. This rules out Lasik surgery for them.
Like Lasik, lens implants are also effective for those with low to moderate myopia.
Their growing popularity here is mirrored globally.
Worldwide, a lens is implanted every 10 minutes today, compared to one every 20 minutes in 2008. These figures came from The European Society of Cataract and Refractive Surgeons’ symposium in Paris last Thursday.
This is despite the high cost of the procedure – about $4,000 per eye. This works out to be about thrice the cost of Lasik, which can start from around $1,000.
 Mr Teo Yen Kai, 29, had contact lens implants for his eyes this March. He said the $8,500 he paid for the operation was worth the cost as he no longer needs to wear spectacles or contact lenses.
The engineer had high myopia of 1,200 and 1,300 degrees in his right and left eye respectively, and 75 degrees of astigmatism in both. This made him more suited for
implants.
“My job requires me to travel often and to put in long hours. For example, I have been at work for 14 hours today,” he said when speaking to this reporter.
Mr Teo is also a mountaineer. He was the first Singaporean to scale Mount Everest in 2005.
He had experienced discomfort with his contact lenses while climbing. His decision to have the procedure was spurred by his plans to go on future expeditions.
At present, about 14 clinics offer ICL, including Singapore National Eye Centre (SNEC) and Tan Tock Seng Hospital.
The implants can also correct astigmatism of up to 600 degrees and long-sightedness of up to 1,000 degrees. Lasik can correct astigmatism and long-sightedness of up to 600 degrees.
“The technology is still not as well-known as Lasik, but it has been gaining ground recently,” said Dr Leonard Ang, the medical director of Premium Lasik Surgery Clinic and The Eye & Cornea Transplant Centre.
“More are seeking this option,” said Dr Ang, who performs the procedure on five to 10 patients every month.
Ophthalmic surgeon Cheryl Lee of the Eye, Cataract & Retinal Specialist Centre said that the implants’ popularity can be attributed to word-of-mouth advertising.
“The word has now spread far and wide. I have had patients who flew here from Mongolia and Russia for the procedure,” said Dr Lee.
This is in stark contrast to earlier days, when her first few patients were all Europeans.
The procedure is well-known in Europe, having been available there since 1997.
Apart from being able to produce better-quality vision than Lasik for people with high myopia, implants have fewer after-effects like dry eyes, haloes (rings around light sources) and starbursts, said Dr Ang.
 Finance executive Jenny Lam, 33, who had both Lasik and implant surgery last month, said she found better results with the latter.
Her right eye was corrected with Lasik, while she had implant surgery on her left eye. This is because she had higher myopia of 1,000 degrees in her left eye, compared to 850 degrees in her right eye.
She also had 100 degrees of astigmatism in both eyes.
“My left eye has perfect vision now because of the implant, but the vision in my right eye is still a little blurry,” said Ms Lam, who needed spectacles from age 10. “Lasik also caused extreme dryness in my eye, which was very uncomfortable.”
She opted for this unusual combination of eye surgery also because of the high cost of ICL.
Another benefit of implants is that it is reversible. Dr Lee said that this boosts the chances of getting good results should a person need cataract surgery when he gets older. In such cases, the implants are removed and replaced with another type of lens that corrects cataracts.
In comparison, Lasik patients who later need cataract surgery may not get as good results. Dr Lee said that the removal of corneal tissue during Lasik may make it more difficult to accurately calculate the power of the replacement lens.
However, implants have their downside too, apart from being expensive.
The main disadvantage is that it is more invasive than Lasik, said Professor Donald Tan, the medical director of SNEC. “Inserting the lens implant involves operating on the inside of the eye, rather than only on the cornea, like in Lasik – so it will always carry a slightly higher risk of infection,” he said.
Hence, Prof Tan said, patients will generally be discouraged from choosing implants if they are eligible for Lasik.
This is also because Lasik has a longer track record, he added.
 Implants versus Lasik
■ Implants can treat myopia of up to 1,900 degrees per eye, while Lasik is limited to a maximum of 1,200 to 1,400 degrees.
■ Implants can treat long-sightedness of up to 1,000 degrees. Lasik is limited to a maximum of 600 degrees.
■ Both implants and Lasik can treat astigmatism of up to 600 degrees.
■ An implant surgery takes 10 minutes to perform – the same time needed for a Lasik procedure.
■ There are fewer after-effects like dry eyes, haloes (rings around light sources) and starbursts after an implant operation.
■ An implant operation is reversible and allows for cataract surgery in future. The removal of corneal tissue during Lasik may make it more difficult to accurately calculate the power of the replacement lens to treat cataracts.
■ Implants costs about $4,000 per eye. Lasik starts from $1,000.
■ It is more invasive than Lasik.
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