Implantable Contact Lenses (ICLs)
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ICLs are an advanced vision correction alternative to treat short-sight, long-sight, astigmatism and presbyopia.
Tiny contact lenses are surgically inserted inside the eye to permanently correct your eyesight without reshaping the cornea, like laser eye procedures.
ICLs are reversible and cause less dry eye than laser eye surgery.
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.
Implantable Contact Lenses
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.
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.
How Do ICLs Correct Vision?
Implantable contact lenses improve eyesight by adding refractive power inside the eye to correctly focus light rays onto the retina.
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.
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.
ICL surgery takes 20-30 minutes per eye and is done as an outpatient procedure under numbing drops. Patients can usually return to their normal routines within a couple of days. Patients are counselled not to expect perfect vision. However, most patients achieve eyesight that matches or exceeds what they could see with their glasses or contact lenses.
Benefits of ICL Surgery
Compared to alternatives like LASIK, PRK, and cataract lens implants, ICL surgery offers several advantages. With millions of Visian 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.
What Prescriptions Can ICLs Treat?
ICls are available for most prescriptions, including astigmatism and reading glasses. The main limiting factor is the depth of the eye’s front chamber, called the anterior chamber.
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.
Suitability for ICL Surgery
If you are frustrated with glasses or contact lenses or have been told LASIK 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.
General requirements to be a good ICL candidate include:
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.
Have a question about ICL Surgery? Get in touch today
ICLs Surgery Steps
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Your eye is first numbed with anaesthetic drops so you feel no pain. Your pupils are dilated with additional drops.
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A speculum keeps your eye gently open during the procedure. It feels like you are still blinking, so just relax and blink normally!
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A small 3mm incision is made at the base of your cornea. This keyhole entry point gives access to the eye for your surgeon.
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The ICL is folded and inserted through the keyhole incision. It unfolds behind the iris where it sits firmly in place.
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Once inserted behind the iris, the doctor will adjust the ICL to ensure proper positioning inside the eye.
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Because this incision is so small, in most cases, it is self-sealing. No stitches are needed after the operation. That’s it!
Who is Not Suitable for ICL?
Have a question about ICL Surgery? Get in touch today
How to Prepare for ICL Surgery
Proper physical and mental preparation helps everything go according to plan before, during and after your LASIK treatment. Taking the following steps helps set the stage for the smoothest LASIK experience and recovery:
Learn If You Are Suitable
Have a comprehensive eye exam to determine if ICL surgery is appropriate and meets the criteria set by your eye surgeon.
Contact Lenses
If you are a contact lens wearer, you must discontinue wearing contact lenses for 1 to 4 weeks before your treatment, depending on the lens type.
Dry Eyes
Follow your ophthalmologist’s instructions on treating dry eyes before surgery.
Getting Home After
Make arrangements for transportation on the day of surgery, as you cannot drive immediately after.
Rest Your Eyes
Limit your screen time and get good sleep in the days leading up to surgery to rest your eyes.
No Products!
Avoid wearing cosmetic products like eyeliner, mascara and perfume around your eyes before the procedure.
Preparing for ICL Surgery
Preparing for ICL treatment involves:
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
Alternatives to ICL Surgery
The most common alternatives to ICL are laser treatments: LASIK, PRK, LASEK or SMILE eye surgery. If you are 50+, refractive lens exchange (RLE) may be an option.
Photorefractive Keratectomy (PRK)
The final vision is the same as LASIK but with more discomfort or pain during healing. PRK is better for thinner or weaker corneas.
LASEK
LASEK is an almost identical procedure to PRK, but the epithelial layer is returned rather than removed.
SMILE
Small incision lenticule extraction is a laser eye treatment for short-sight, aka SMILE, CLEAR, and SILK.
LASIK
A popular laser eye surgery with fast recovery. A flap is created and replaced after reshaping your cornea.
RLE (Refractive Lens Exchange)
Exchanging the eye’s natural lens with a premium intraocular lens implant to restore vision. Suitable for ages 50+.
Glasses or contact lenses
The final option is to continue with glasses or contact lenses. The risk of vision loss is higher with contacts than with LASIK.
ICL vs LASIK
The most common alternative to ICL treatment is LASIK laser eye surgery. LASIK is generally the first choice, but you may not be suitable. If not, ICL can be an excellent choice. See the table 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.
ICLs offer a unique advantage: they preserve 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.
FEATURES | ICL | RLE |
20-60 | 50+ | |
Up to -18D (dioptres) | Up to -25D (dioptres) | |
1 in 3,000 | 1 in 3,000 |
ICL vs PRK
Another alternative to ICL is photorefractive keratectomy or PRK.
PRK is mainly used instead of LASIK for patients with thinner corneas or those participating in contact sports. However, the prescription range treatable by PRK is limited compared to ICLs.
Many surgeons who offer ICLs would use this approach for prescriptions above -8.00 dioptres short-sighted or above +3.00 long-sighted.
FEATURES | ICL | RLE |
20-60 | 50+ | |
Up to -18D (dioptres) | Up to -25D (dioptres) | |
1 in 3,000 | 1 in 3,000 |
Have a question about ICL Surgery? Get in touch today
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 £4,000-£4,500 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.
ICL Frequently Asked Questions
What is ICL surgery?
ICL surgery involves the placement of a Collamer lens inside the eye, between the iris and the natural lens. This lens works with the eye’s natural lens to correctly focus light on the retina, improving vision. It’s typically used to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.
Who is eligible for ICL surgery?
Ideal candidates are typically between 21 and 45 years old, with stable vision prescriptions for at least a year. The surgery is especially beneficial for patients with thin corneas or dry eyes who may not be suitable for LASIK. Patients should not have a history of eye diseases like glaucoma or cataracts.
What are the risks of ICL surgery?
Like any surgical procedure, ICL carries risks, though serious complications are rare. Potential side effects include increased intraocular pressure, cataract development, inflammation, infection, halos, and glare. It’s essential to discuss these risks with your surgeon.
How long does the ICL procedure take?
The surgery itself is relatively quick, often taking less than 30 minutes per eye. However, the entire process, including preparation and post-operative checks, may take a few hours.
What is the ICL recovery process like?
Recovery from ICL surgery is typically quick. Many patients notice improved vision immediately, with stabilization over a few days to weeks. You may need to use prescribed eye drops to prevent infection and inflammation and will have follow-up appointments to monitor healing.