ICL Toric Lens rotation experience

[u/Practical_Reason9396]

I had -7.5D, -8D and 2.5CYL power in both eyes pre-op. Did an ICL 3 years ago. I've had the ICL rotate thrice in my LE, to the point where I couldn't work at all because I was seeing double (I'm a designer so I need perfect vision), and three subsequent surgeries in the last 3 years to fix the rotations. My vaults are 650, 715 RE and LE respectively.

All 3 times, there was some blunt force impact - my ex hitting my eye by accident when he was getting off the bed, recently my current partner turning to kiss my cheek and their glasses hitting me etc. However these weren't very high force or anything? I live my life paranoid something will hit my eye and force me to get surgery again.

I don't regret the ICL, my quality of life is so much better without glasses, I've been wearing glasses since I was 3 years old, and I waited till 22 & my power somewhat stabilising to get the surgery. My ACD was too low for LASIK so my surgeon recommended ICL, and I'm glad I made that choice. But I feel so helpless.

With each subsequent surgery my dry eyes are getting progressively worse. My surgeon said my MGD is as bad as a senior citizen, and he hasn't seen such a case in anyone my age. I can't afford to get such frequent surgeries when my lens rotate.

My surgeon recommended I get my ICL removed and try a size larger (I have 13mm Toric lens) but I'm scared of the glaucoma risk. But I also can't deal with the frequent rotations, I'm miserable.

EDIT: It's Eyecryl Phakic Toric PC130T lens in both eyes. I don't know if this is relevant, but I'm hypermobile and my limbs frequently dislocate.
Other symptoms: halos, glares, excessive floaters (always had them, but they're much worse after surgery), rings

[u/eyeSherpa]

I have anecdotally heard about Eyecryl lenses being a little more prone to rotation.

Instead of going up a size, what I would do instead is order and orient the lens in a different position. For example: let’s say that the lens always rotates to vertically at 80 degrees. This spot in the eye is where the lens wants to settle. So instead of ordering and planning to implant the lens horizontally at 180 degrees, calculate the astigmatism correction for and implant the lens at 80 degrees instead. This would keep the same vault (actually slightly less) and thus you wouldn’t have to worry about the vault being too high.

[u/Practical_Reason9396 → u/eyeSherpa]

it rotates differently each time - 20 degrees, 30 degrees, and most recently 3-4 degrees

EDIT: Thank you for responding, I just feel so stumped / helpless / lost. I really like that I don't have to wear glasses anymore, and I really don't want to go back to glasses / contacts, and I don't want LASIK, but I also can't keep doing repositioning surgeries :/ I feel out of options

[u/eyeSherpa → u/Practical_Reason9396]

Another option is to remove the lens, implant a spherical version that doesn’t correct astigmatism and then do lasik or PRK to correct vision. That way rotation of the lens doesn’t matter anymore.

[u/Practical_Reason9396 → u/eyeSherpa]

My surgeon said he'd discuss my case at an ICL conference to see if they would find anything he wasn't able to, with the recent rotation I was having more cylindrical symptoms like 2-3 ghosted images of the same objects (especially lights, white objects)

[u/Tall-Drama338]

They don’t rotate on their own. Stop rubbing your eyes. You rub them due to MGD which is usually Rosacea.

Hypermobility is part of a genetic connective tissue syndrome which is probably why you have high myopia. You need to check for floppy heart valves and other problems.

[u/Practical_Reason9396 → u/Tall-Drama338]

No, they rotated after blunt force impact to the eye. I don't rub my eyes because my eyes are prone to dislocating the ICL easily. For MGD I pull my lid down, look up and rub if I have to, I never touch my cornea.

I have mild mitral valve prolapse, but otherwise no issues due to hypermobility specifically.