ICL for Myopia: Benefits and Eligibility

Myopia, or nearsightedness, causes distant objects to appear blurred because light focuses in front of the retina instead of directly on it. Glasses and contact lenses can correct this refractive error, while refractive procedures may help suitable patients reduce their dependence on corrective lenses.

ICL for myopia is one such option, particularly for people who may not be suitable candidates for corneal laser procedures or who have higher refractive errors. Unlike LASIK, ICL surgery does not reshape or remove tissue from the cornea. Instead, a specially designed lens is placed inside the eye while the natural lens remains intact.

At Surya Eye Hospital, refractive assessment considers the prescription, cornea, internal eye anatomy and overall ocular health before a procedure is recommended. This detailed evaluation helps determine whether ICL, LASIK or another form of vision correction is appropriate for the individual eye.

What is ICL for Myopia?

An Implantable Collamer Lens, commonly called an ICL, is a lens placed inside the eye to correct refractive errors such as myopia. It works with the eye’s natural lens rather than replacing it.

The lens is positioned behind the iris, the coloured part of the eye, and in front of the natural crystalline lens. Once correctly positioned, it helps focus incoming light more accurately onto the retina.

Unlike LASIK and some other laser vision correction procedures, ICL surgery does not involve reshaping the cornea. The cornea therefore remains structurally unchanged by the refractive correction itself.

The implanted lens also cannot normally be seen by another person. Patients do not need to remove, clean or replace it daily as they would with regular contact lenses. ICL is a form of phakic intraocular lens surgery. The word “phakic” indicates that the eye’s natural lens remains present.

What Are the Benefits of ICL for Myopia?

ICL can provide effective refractive correction without removing corneal tissue. Its characteristics can make it worth considering for selected patients with moderate or high myopia or when corneal laser treatment is unsuitable.

Potential benefits include:

• No corneal tissue removal: ICL changes how light is focused through an implanted lens rather than permanently reshaping the cornea.
• Correction of higher levels of myopia: ICL technology can correct refractive errors beyond the ranges suitable for some corneal laser procedures, depending on the lens used.
• An option for some patients with thinner corneas: Corneal thickness can limit procedures that require tissue removal. However, having a thin cornea alone does not establish ICL eligibility.
• The natural lens remains intact: ICL is placed in front of the natural crystalline lens instead of replacing it.
• The lens can be removed or exchanged: An ophthalmic surgeon can remove or replace an ICL if clinically required, although this would involve another intraocular procedure.
• Correction of myopic astigmatism: Toric ICL models may correct both myopia and astigmatism in suitable patients.
• Limited effect on corneal biomechanics: Because the refractive correction occurs inside the eye, corneal tissue is not reshaped as it is during LASIK or similar procedures.

ICL should not automatically be considered “better” than LASIK. Each approach has different benefits, limitations and eligibility requirements. The choice depends on the person’s prescription, corneal characteristics, internal eye measurements, age and overall ocular health.

Who is Eligible for ICL Surgery?

ICL eligibility is determined through a detailed eye examination rather than spectacle power alone. A suitable candidate generally needs a stable refractive error, adequate space within the eye and healthy ocular structures.

Several factors are considered during assessment.

A refractive surgeon must therefore assess the entire eye before deciding whether ICL is suitable.

Who May Not Be Suitable for ICL?

Some people may not be appropriate candidates for ICL, while others may require additional testing before a decision can be made. Suitability depends on the anatomy and health of the individual eye.

Factors requiring careful evaluation can include:

• inadequate anterior chamber depth;
• unsuitable corneal endothelial cell count;
• unstable refractive power;
• cataract;
• glaucoma or raised intraocular pressure;
• active or recurrent inflammation inside the eye;
• certain retinal or macular conditions;
• previous eye surgery or structural abnormalities; and
• pregnancy or breastfeeding when refractive measurements may be changing.

Medical history also matters. The ophthalmologist may postpone surgery or recommend another approach if an ocular or systemic condition could affect healing or surgical safety.

What Tests Are Done Before ICL Surgery?

Before ICL surgery, the ophthalmologist measures both refractive error and the structures inside the eye. These investigations help determine candidacy, select an appropriate lens and identify conditions that could alter treatment planning.

At Surya Eye Hospital, assessment for refractive procedures includes examination of the prescription, cornea, eye anatomy and overall ocular health.

The evaluation may include:

• Refraction and prescription stability: Repeated measurements help establish the amount of myopia and astigmatism and whether the prescription has remained sufficiently stable.
• Corneal assessment: Corneal thickness, curvature and shape may be measured. These findings also help compare ICL with corneal laser options.
• Anterior chamber measurements: The ophthalmologist evaluates the space between the cornea and natural lens. Adequate dimensions are important for appropriate ICL positioning.
• Endothelial cell assessment: A specialised test measures cells on the inner surface of the cornea. These cells play an important role in keeping the cornea clear.
• Intraocular pressure: Eye pressure is measured to identify raised pressure or possible glaucoma-related concerns.
• Natural lens examination: The eye is checked for cataract or other lens changes that could influence whether a phakic ICL is appropriate.
• Retinal examination: A dilated retinal examination may be advised, particularly in patients with high myopia, because significant myopia can itself be associated with retinal abnormalities.

These measurements are considered together. A favourable spectacle prescription does not override an anatomical or ocular-health concern.

Read More:

ICL vs LASIK: Which Vision Correction Procedure Is Right for You?

What Happens During ICL Surgery?

ICL surgery involves placing a specially selected lens behind the iris and in front of the natural lens. The procedure corrects refractive error without removing the eye’s natural crystalline lens.

The main steps include:

• Eye preparation and anaesthesia: The eye is cleaned and numbing eye drops or other appropriate anaesthesia are used to minimise discomfort during the procedure.
• Small corneal incision: The surgeon creates a small opening at the edge of the cornea to allow insertion of the folded ICL.
• Lens insertion: The folded lens is gently introduced into the eye through the small incision.
• Positioning behind the iris: Once inside the eye, the ICL unfolds and is carefully positioned behind the iris and in front of the natural lens.
• Final position check: The surgeon checks the lens position, alignment and its relationship with surrounding eye structures before completing the procedure.
• Postoperative monitoring: Eye pressure, vision and healing are monitored after surgery. Follow-up visits help confirm that the lens remains correctly positioned and the eye is recovering as expected.

The exact surgical steps may vary depending on the ICL model, eye anatomy and the surgeon’s assessment. Patients should follow the preparation and aftercare instructions provided by their ophthalmologist.

Recovery, Possible Risks and Follow-Up After ICL

Vision may begin improving relatively early after ICL surgery, but recovery differs between patients. Follow-up visits remain important because the ophthalmologist needs to assess healing, lens position, eye pressure and visual correction.

Patients may temporarily notice blurred vision, light sensitivity, glare, halos or mild discomfort. Prescribed eye drops should be used according to the surgeon’s instructions, and rubbing the operated eye should be avoided during early healing.

Activities such as driving, strenuous exercise, swimming and returning to work should be resumed according to individual medical advice rather than a fixed internet timetable.

ICL is an intraocular procedure and therefore carries recognised risks. These can include:

• raised intraocular pressure;
• inflammation;
• infection;
• cataract formation;
• endothelial cell loss;
• glare or halos;
• residual refractive error; and
• problems related to lens sizing, position or the space between the ICL and natural lens.

These complications do not occur in every patient, and modern assessment and lens sizing are designed to reduce avoidable risks. However, patients should understand both benefits and possible complications before choosing surgery.

What is the Cost of ICL Surgery?

The cost of ICL surgery can vary depending on the lens selected, the refractive power being corrected, preoperative investigations and the treatment plan. A detailed eye examination is therefore required before the final cost can be determined.

Factors that may influence ICL surgery cost include:

• Type of ICL: The lens model and whether a toric ICL is required for astigmatism can affect the treatment cost.
• Lens power and planning: The required refractive correction and individual eye measurements determine the lens selected.
• Pre-surgery investigations: Corneal, anterior chamber, endothelial cell, retinal and other assessments may form part of treatment planning.
• Individual eye condition: Additional evaluation or management may be required when other eye conditions are identified.

At Surya Eye Hospital, the ophthalmologist first assesses whether ICL is appropriate for the patient before finalising the treatment plan and associated cost.

FAQs

Is ICL suitable for people with high myopia?

ICL may be suitable for some people with high myopia, particularly when their prescription lies outside the preferred range for corneal laser treatment. Eligibility also depends on anterior chamber measurements, endothelial cells, retinal health and other eye findings.

Does having a thin cornea mean I should choose ICL?

Not necessarily. ICL does not require corneal tissue removal, so it may be considered when corneal thickness limits laser correction. However, internal eye measurements and overall ocular health must still meet appropriate clinical requirements before surgery.

Is ICL better than LASIK for myopia?

Neither procedure is universally better. LASIK reshapes the cornea, while ICL corrects vision using a lens placed inside the eye. The more appropriate option depends on prescription, corneal characteristics, eye anatomy, age and individual clinical findings.

Can an ICL be removed later?

An ICL can generally be surgically removed or exchanged if there is a clinical reason to do so. This does not mean implantation should be considered temporary, because removing or replacing the lens requires another intraocular procedure.

How long does recovery take after ICL surgery?

Early visual improvement can occur relatively soon, but recovery and stabilisation vary between patients. Follow-up examinations are needed to check vision, eye pressure, lens position and healing before activities such as driving or strenuous exercise are resumed.