Side effects and truths about implantable contact lenses that ophthalmology clinics don’t tell you

First, I had Artisan lens implantation around age 20, and thankfully I’ve been living for nearly 15 years without major side effects. I had ultra-high myopia of about -9 and -10 in the left and right eyes, and because my eyesight was so poor, a lot of cornea would have had to be ablated, so I was told I was unsuitable for LASIK and LASEK. Wearing thick glasses had been a complex since I was young, so without even looking into it properly, I just went ahead with the surgery. At the time, the hospital only told me about minor expected side effects like glare or dry eye syndrome, and thankfully the surgery went well. Even so, because of several facts about lens implantation that I learned after surgery, I always live with anxiety, and before undergoing surgery, if I had known in advance, I think I would have gone into the surgery with a different level of resolve. First, before explaining, you need to know that behind the cornea of our eyes are essential cells that maintain vision, called corneal endothelial cells. When we are born as newborns, we have 4,000-5,000 of them, and as we age and become adults, they naturally drop to 2,500-3,000. In old age, they decrease to below 2,000. Very low corneal cell counts mean permanent vision loss, and 500 or fewer is a level of visual impairment requiring corneal transplantation. Because implantable lenses are inserted behind the cornea, where these endothelial cells are located, the risk of endothelial cell loss is higher than in eyes without foreign bodies like lenses. Below are facts related to this that you absolutely need to know. 1. Because damage inevitably occurs during lens implantation, this cell count drops by tens to hundreds, and unlike other cells in our body, cells that disappear once never recover. 2. If the cell count drops below 2,000, lens removal should be considered, and it must be removed before it drops to 1,500. Once it becomes 1,000 or lower, removal surgery may not be easy due to the risk of various complications, and if it is 500 or lower, corneal transplantation may be necessary. 3. The way to prevent endothelial cell loss after surgery is to avoid impact to the eyes. No matter how much time passes, for life you have to avoid rubbing your eyes, pressing them hard, and hobbies or sports that could injure the facial area. 4. Even with good management, there are cases where the cell count suddenly plummets for an unknown reason. There are cases where people have no problems at all for 10 years, and then one day their cell count suddenly drops rapidly and they have to remove the lenses. Thankfully, mine has not been dropping beyond the natural decrease over 15 years, but I’m always a little sensitive about whether something might happen to my eyes. 5. If side effects occur after lens implantation and the lenses are removed, vision does not return even to the original level. Many ophthalmology clinics explain it as if, if a problem occurs, you can just remove the lenses, making side effects sound easy to resolve. But the problem is that, as mentioned above, inserting and removing lenses inevitably damages the cornea and endothelial cells, so vision does not simply return to the preoperative level. Of course, just like plastic surgery clinics, ophthalmology clinics probably won’t mention the above when you go for a consultation, or won’t emphasize it strongly. If you think only about risks, there may be no surgery in the world you can receive, but I believe that at least having as much information as possible before surgery is a patient’s right, and that it allows you to respond quickly if a problem occurs. I’ll stop here, hoping this helps everyone who is about to undergo vision correction surgery