A Complete Guide to ICLs
Your 2024 complete guide to Implantable contact lenses (ICLs). ICLs represent an advanced vision correction alternative to treat short-sight, long-sight, astigmatism and presbyopia. Tiny lenses are surgically inserted inside the eye to permanently correct your eyesight without reshaping the cornea, like laser eye procedures.
This in-depth guide covers all aspects of ICLs, including:
how they work
benefits
suitability
surgical procedure
recovery
costs
risks
finding the right surgeon
Read on to fully understand this innovative approach to achieving clear, natural vision without glasses or contacts.
What are Implantable Contact Lenses?
Implantable contact lenses (ICLs) are small, soft polymer lenses surgically placed inside the eye between the iris and the natural lens to correct your sight. They are designed to permanently improve vision, so glasses and contact lenses are no longer needed. 【source】
ICLs are made from a specialised material called Collamer that is biocompatible, flexible, and highly transparent. The lenses come in different sizes and prescriptions to match each eye’s specific focusing needs.
During ICL surgery, the implant lens is folded up into a very small injector and inserted through a tiny incision in the eye. Once positioned behind the iris, the ICL unfolds and provides continuous focusing power to properly direct light onto the retina for crisp, clear vision at all distances.
Unlike LASIK, which alters the shape of the cornea using a laser, ICL surgery leaves this outer structure completely untouched. The ICL acts similarly to a contact lens placed inside the natural eye.
Implantable contact lenses are designed to remain in the eye permanently. However, your ophthalmologist can safely remove or exchange them if needed. The Collamer material is highly biocompatible, so the risk of rejection is extremely low. 【source】
How Do ICLs Correct Vision?
Implantable contact lenses improve eyesight by adding refractive power inside the eye to focus light rays onto the retina correctly.
The ICL sits between the iris and your own lens. Light passes through the cornea, then the implant and finally through the natural lens, which provides the prescription power necessary to correct nearsightedness, farsightedness, or astigmatism.
Toric ICL models can treat astigmatism by providing precise cylinder power and axis alignment customised to correct each eye fully. 【source】
Multifocal implantable contact lens options contain different focusing zones to correct both near and far sight, treating presbyopia. Light passing through the centre focuses at distance, while peripheral light focuses for near tasks.
The key is that no corneal tissue is removed or reshaped. The ICL supplements the eye’s focusing ability. By preserving the cornea and natural lens, excellent visual quality is maintained, especially at night.
Suitability for ICL Surgery
If you are frustrated with glasses or contact lenses or have been told LASIK or PRK laser eye surgery is not for you, ICLs may provide the ideal correction solution. But confirming candidacy beforehand is crucial.
Your ophthalmologist will conduct thorough pre-operative tests to determine if ICL surgery is safe and appropriate for your eyes. Examinations evaluate the cornea, internal eye structures, pupil size, and precise refractive error (your glasses prescription) measurements.【source】
General requirements to be a good ICL candidate include:
Stable vision with no fluctuations in your eyeglass/contact lens prescription for at least 1 year
Moderate to high short-sight, long-sight or astigmatism not suited for laser vision correction
Corneas thicker than 480 microns (similar to laser eye surgery)
Pupils under 7 mm diameter in dim light
No corneal disease or cataracts
Motivation to achieve excellent outcomes with less dependence on glasses or contacts
Realistic expectations of ICL surgery benefits and potential limitations
Willingness to follow proper post-operative care instructions
ICLs are approved to treat prescriptions ranging from +10.0 to approximately -18.0 diopters for myopia and hyperopia. The latest models can also correct up to 6 diopters of astigmatism.
Your refractive surgeon will determine if your particular prescription falls within a treatable range. Even if LASIK or PRK laser eye surgery has been ruled out for you in the past, ICLs may provide a safe, effective option for clear, unaided eyesight.
Benefits of ICL Surgery
Compared to alternatives like LASIK, PRK, and cataract lens implants, ICL surgery offers several advantages. With millions of Visian Collamer ICLs implanted worldwide, these phakic intraocular lenses will correct vision problems in a predictable and safe manner. ICL lenses are well understood and are established vision correction treatments.
Implantable collamer lens surgery is less invasive than removing the eye’s natural lens and inserting an intraocular lens, as in standard cataract surgery. The Collamer artificial lens gives better vision than other types of refractive surgery for more extreme prescriptions. 【source】
Expanded Correction Range
Implantable collamer lens procedures can safely treat much higher degrees of nearsightedness, farsightedness, and astigmatism than laser vision correction. This makes them excellent options for those seeking visual freedom outside standard laser eye surgery ranges.
Convenience
Both eyes can have the ICL procedure on the same day if preferred. Most patients choose this option. The quick recovery means the eyes can be used normally the next day.
Preserves Corneal Integrity
No tissue is removed from the cornea, preserving its structure, clarity, and strength. This maintains its natural focusing ability and minimises the risk of dry eyes or corneal ectasia later in life.
Excellent Night Vision
With no corneal disruption, light transmission and image quality at night are excellent—you gain improved vision with minimal risk of halos, glare, ghosting, and starbursts.
Quick Recovery
The Visian implantable collamer lens surgery involves no lengthy healing process. Most patients see well the next day, with stabilisation within 1-2 weeks. Return to regular activity is quick.
Removable & Reversible
Should their prescription change over time, the surgeon can safely remove or exchange an implantable contact lens. This provides options not available with LASIK, PRK, SMILE or cataract surgery.
Stable Vision
Once healed, implantable contact lens surgery provides continuous clear focus not dependent on the lens position like traditional contacts. No regression is possible, or enhancements are needed.
UV Protection
The implantable contact lens includes a UV-protection material built into the lens implant. The protects your retina from harmful UV rays.
Treats Presbyopia
Special multifocal ICLs can correct both distance and near sight, which is important for reading and computer work as we age. Multifocal ICLs are an alternative to mulotifocal IOLs used in refractive lens exchange.
For those struggling with glasses or contacts who want excellent eyesight with fewer potential drawbacks than other eye surgery options, ICLs offer an effective solution.
Alternatives to ICL Surgery
The most common alternative to ICL treatment is laser eye surgery, notably LASIK. See the table below to compare the two procedures side-buy-side:
FEATURES | ICL | LASIK |
Up to -18D (dioptres) | Up to -10D (dioptres) | |
1 in 3,000 | 1 in 21,000 |
ICL vs Refractive Lens Exchange (RLE)
RLE and ICL surgeries share similarities, yet possess distinct differences. Both procedures involve the insertion of an implant lens into the eye. However, in RLE, the natural clear lens is extracted and replaced with an intraocular lens (IOL). RLE typically caters to individuals aged 50 and above.
ICL, or Implantable Contact Lens, offers a unique advantage: it preserves the eye’s natural ability to focus on nearby objects. Placed between the lens and iris of the eye, this procedure is typically performed on patients between the ages of 20 and 50, making it suitable for younger individuals compared to RLE.
ICL Surgery – Before, During & After
Understanding the implantable contact lens surgery process prepares you for the procedure and sets proper expectations for recovery. Both eyes can be treated on the same day if needed. Unlike older ICL designs, no laser treatment is needed before surgery.
Before Surgery
Preparing for ICL treatment involves:
Comprehensive eye exam to determine ICL lens specifics and eye health
Corneal topography, pachymetry, and wavefront measurements
Recording your medical history to ensure you are suitable for lens icl surgery.
Dilated retinal evaluation to confirm a healthy lens and optic nerve
Testing pupil size in various lighting conditions
Discussion of surgical risks, benefits, and alternatives with your surgeon
Review of instructions before surgery day, including medication precautions
Arrange transportation since you cannot drive immediately after
Following all pre-operative instructions helps prevent complications and maximise outcomes.
During ICL Surgery
Having an implantable collamer lens is a quick procedure. On the day of the EVO visian ICL surgery, the steps typically include:
Anaesthetic drops are placed in the eye to numb. Another drop will dilate the pupil
An oral medication to help you relax can be prescribed
Position the patient comfortably under the surgical microscope
The doctor makes a small keyhole incision at the cornea (3.5mm or less)
Viscoelastic fluid injected into the anterior chamber through the small incision
A special injector slides the folded ICL soft lens through the incision
Forceps help position the implant properly in front of the natural crystalline lens
Viscoelastic is removed, and the incision allowed to self-seal
Additional positioning adjustments made if needed
Antibiotic drops are applied
Protective shields protect the eyes until the next day
The procedure takes 15-30 minutes per eye. Both eyes can often be treated during the same surgery session. Patients report little to no discomfort.
After Surgery
Following ICL minimally invasive surgery, you can have low levels of discomfort and a short recovery time. Like all surgical procedures, some prescribed eye drops and precautions are needed to treat patients safely:
You will notice clearer vision within 24 hours, similar to LASIK eye surgery
Wearing an eye shield at night for 1-2 weeks (an eye patch isn’t necessary)
Using antibiotic (protects against eye infection) and anti-inflammatory eye drops for 5-7 days.
Returning to work in 2-4 days
Resuming exercise in 3-5 days
Driving once your eyesight is adequate, often within 1-3 days
Sight becomes clearer each day as your eyes heal
Full recovery within 1-2 weeks
Follow all post-op instructions from your ophthalmologist for proper healing.
ICL Surgery Costs
While more expensive than glasses or contacts, ICL surgery is competitively priced compared to other eye surgery options and provides many years of clear vision without lenses.
ICL Surgery Cost Breakdown
The overall cost of ICL surgery includes:
Surgeon/Physician Fees
Surgical Facility Fees
Implantable Contact Lenses
The total cost is generally £7,000 to £8,500 for surgery on both eyes.
This is more expensive than LASIK (around £4,400-£5,000 for both eyes), but the ICL procedure provides permanent vision correction for those unsuitable for laser vision correction.
Insurance Coverage for ICLs
Since implantable contact lenses are an in-eye procedure to correct refractive errors, including cataracts, insurance plans may cover some of the cost. Coverage varies significantly by plan.
Insurance plans typically only cover annual eye exams and glasses/contacts. However, medical insurance may pay for part of ICL surgery when deemed medically necessary, especially for extreme nearsightedness.
Check with your specific insurance provider to understand potential coverage. Reputable surgeons will provide billing assistance. Financing options are also available to make costs more manageable through low monthly payments.
Long-Term Value of ICL Surgery
While costly upfront, correctly performed ICL surgery provides permanent vision correction without needing glasses or contact lenses after recovery. This saves considerable time and expense over a lifetime otherwise spent on:
Eyeglasses – New prescription lenses every 1-2 years
Contact lenses – Ongoing costs for supplies plus annual exam fees
Laser enhancement – As eyes change over decades
Considering the cumulative costs incurred with glasses, contacts, and repeat eye surgeries, ICL implantation provides good value for suitable candidates who can enjoy clear, unaided vision indefinitely after surgery.
Risks and Limitations of ICL Surgery
While ICL surgery is highly safe and effective in treating blurry vision when properly performed on well-qualified candidates, there are still risks to consider, as with any eye surgery.
Potential ICL Complications
Rare risks include:
Infection – Treated with prescription antibiotic eye drops
Inflammation – Well controlled with steroid medication
Under/over correction – Fixed with ICL exchange
Lens rotation – Repositioned if bothersome visually
Cataracts – Slow development in some patients
Corneal swelling – Temporary and managed with drops
Your ophthalmologist will discuss risks in detail at your consultation. Follow all pre and post-op instructions to minimise complications.
Vision Limitations After ICL Surgery
While most achieve 20/20 or better, some limitations can include:
Night vision issues if pupil size was inadequately considered
Need for reading glasses over time
Rainbow glares around bright lights
Occasional double vision if healing is off-centre
Proper sizing and implantation technique minimises the risks of visual aberrations. Discuss any concerns thoroughly with your surgeon.
Long-Term Considerations
Since the lenses are designed to last over a decade, eventual replacement may be needed for changing prescriptions or if cataract surgery becomes necessary later in life. ICLs do not halt the natural ageing of the eyes.
Finding an Experienced ICL Surgeon
Choosing a highly qualified consultant ophthalmic surgeon specialising in implantable contact lenses is crucial for safe, effective outcomes.
What to Look For
See a surgeon who:
Is certified in ophthalmology with fellowship cornea and refractive surgery training
Provides adjustable ICL sizing based on multiple eye measurements
Uses advanced power calculations for precision vision correction
Has extensive experience performing hundreds of ICL procedures with excellent outcomes
Offers the latest Visian ICL lens models from STAAR Surgical
Can treat high degrees of nearsightedness and astigmatism correctly
Customises surgery to each patient’s unique eye characteristics
Welcomes you to speak with prior ICL patients about their experience
Questions to Ask Your Surgeon
Important questions include:
How many ICL procedures do you perform annually?
What is your patient satisfaction rate and complication rate?
Which ICL products and sizing methods do you use? Are they the latest?
How customised will my ICL selection and surgery be?
Should I have wavefront-guided LASIK or PRK instead? Why or why not?
What limitations might I still have after surgery?
What is your enhancement policy if the sight is under-corrected?
Choose a responsive surgeon you trust who addresses all queries thoroughly.
Are ICLs Right for You?
Implantable collamer lenses offer improved vision and are an excellent alternative to eyeglasses, traditional contacts, and laser procedures for those with moderate to high shortsightedness, long-sightedness, or astigmatism.
The EVO Visian ICL procedure is now an established vision correction option, especially for severe myopia, thin corneas or higher amounts of long-sightedness where laser eye surgery isn’t recommended.
Candidates must have healthy eyes and a stable prescription suitable for Visian ICL surgery. Motivation for excellent sight with less eyewear dependency is vital.
Carefully review the benefits, risks, and costs. Talk to me to determine if ICL surgery is appropriate to correct your prescription.
For those wanting quality eyesight without glasses or contacts, ICLs may provide the solution you’ve been waiting for!