DAPHNE, Ala.—Kasandra Madsen has been legally blind for nearly half her life. She cannot see out of her left eye and has little peripheral vision out of her right one.

But a new corrective procedure, involving the insertion of a permanent contact lens over her eye, will help Madsen see clearer than she ever has before.

A native of Pensacola, Fla., Madsen has had vision problems since she was born and has worn eyeglasses since she was 2 years old.

Madsen—a cashier in the Daphne High School cafeteria—struggles with extreme nearsightedness, or myopia, a condition that causes blurred distant vision.

Madsen can perform functions at her job with relative ease, although reading menus can present difficulties. “If I have to read small print, I have to take my glasses off,” she said.

“(The doctors) figured it out when I was about 10 or 12,” she said of her condition. “They diagnosed it as a toxoplasmosic scar.”

The scarring of her eyeball during fetal development left Madsen with no vision in her left eye.

“If I take off my glasses, I can’t see two feet in front of my face,” she said.

“I didn’t get my driver’s license until I was 21,” she said. “It still makes it hard driving at night.

“I can’t see street signs,” she added. “I drive by landmarks.”

Madsen was never a candidate for previous corrective surgeries, most notably Lasik, a popular procedure that uses laser technology to remove tissue from the eye.

“Nobody would do the surgery because without my left eye, I would be too much of a risk,” she said.

But the Visian ICL—an implantable collamer lens, involving a corrective surgery that allows patients with serious vision problems to have their sight restored—later became an option.

The implant—made from a soft, plastic and collagen-based material—is similar to lenses used to correct vision after cataract surgery.

In its most simplified form, the surgery is like inserting a permanent contact lens over the eye, according to Dr. Joseph Gravlee Jr., the opthamologist performing Madsen’s operation Tuesday.

“It does the same job as a contact lens but rather than floating on a surface, it’s permanent,” he said.

The lens is placed— through a small incision—within the back chamber of the eye, directly behind the iris, before the eye lens.

“They’re going to numb my eyeball,” Madsen said. “They’ll insert some gel in my eye. Then, they’ll insert the tube (inside which the lens is rolled); they’ll remove the tube and the lens will stay inside the eye.”

The implant will focus light on the retina, permanently correcting any myopic effects.

“The beauty of the ICL is that it doesn’t weaken the cornea,” Gravlee said, adding he learned the technique in the Dominican Republic five years ago, when it was not government-approved.

“A lot of companies will do their trials overseas,” he said. “It’s been done in Europe and South America for a long time now.”

The surgery comes with risks.

“The main risk would be infection because you’re opening the body up to the outside,” Gravlee said. “She can have problems with glaucoma and also induced cataracts.”

“I could get an infection. My vision could get worse than it is now,” Madsen said.

Still, she said, “even if I have to wear glasses that aren’t as thick, I’m willing to risk it.”

Madsen said she wasn’t nervous about Tuesday’s procedure until she found a video of the surgery on the Internet.

“I wasn’t too nervous until I found a link on YouTube with a video of the procedure,” she said, wide-eyed.

ICL surgery, compared to alternatives, is expensive because it is still relatively new; it received governmental approval in 2005, according to the Food and Drug Administration’s Web site.

“It’s very expensive; about $3,500 per eye,” Madsen said. “Insurance won’t cover it because it’s considered cosmetic.”

Gravlee cites the surgery’s labor-intensive process as the reason for its high cost.

“It takes more nurses and more drugs are involved,” he said. “It’s just a lot more work.”

The surgery is not for everyone; certain age restrictions apply. An ideal candidate for the surgery is between ages 21 and 45.

“People in their 50s develop cataracts; people under 21 have eyes that are still growing,” Gravlee said. “People under 40 respond well to the surgery.”

Andrea Thompson, clinical audiologist, is just such a person. She had the ICL implant procedure almost three years ago and is pleased with the results.

 “(The change) has been dramatic,” she said. “Since I was eight years old, I’ve worn contacts or glasses.

“I used to fumble around in the dark,” she added. “Now, it’s nice to be able to see, to just wake up and go.”

A 2002 clinical study of 294 patients was conducted to evaluate the benefits of this surgery.

According to the Food and Drug Administration, three years after implant insertion, 94.7 percent of participants reportedly could see with 20/40 vision—the requirement to drive a vehicle in the U.S. with corrective lenses.

The 20/20 designation, or perfect vision, is based on an individual who can see an eye chart clearly at 20 feet with both eyes open.

The Tuesday procedure won’t come soon enough for Madsen, who anticipates a similar dramatic impact as Thompson experienced.

“I’m getting there,” she said. “I’m just ready to get it over with.”

Don’t miss the Saturday, Feb. 7 Daphne Bulletin, when we’ll follow-up with Kasandra Madsen and her vision-correction surgery.