ICL Surgery: What to Expect

Dr. Russel Lazarus, February 25, 2021
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Over 1 million ICLs have been implanted globally.

An implantable collamer lens (ICL) is an artificial lens that’s permanently implanted in the eye, this surgical procedure is used to treat myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.

The benefits of ICL include:

  • Corrects medium to high levels of myopia (nearsightedness)
  • Reduces likelihood of dry eye
  • Provides great night vision
  • Is replaceable
  • Quick recovery
  • Great option for those who can’t have laser eye surgery

If you are interested in ICL surgery visit your eye doctor to find out if you are a good candidate. 

The Find an Eye Doctor directory provides a list of eye doctors near you who can conduct a consultation and discuss the ICL option with you.

Find an eye doctor near you

ICL surgery

ICL surgery is keyhole surgery similar to cataract surgery.

The ICL is folded and inserted into the eye. The lens implant is correctly positioned behind the iris, where the ICL will gently unfold. The procedure is performed under local anesthetic with sedation as needed.

Side effects after the procedure may include sensitivity to light, discomfort of the eyes and glare from lights in the dark, and blurry vision. These side effects are only temporary. Blurry vision will last only a few days, while sensitivity to light may last a few weeks. All side effects should diminish over time.

During the surgery a laser will be used to make tiny holes between the front of the eye and the natural lens. This will help prevent pressure and fluid buildup in the eye after the procedure.

Antibiotics or anti-inflammatory eye drops may be given several days before surgery.

The ICL procedure is performed by an eye surgeon and here’s what to expect during the surgery:

  1. A mild topical or local anesthetic is given to numb to reduce any sensations and feeling from the eye. This all happens while on your back.
  2. A mild sedative might also be given to help you relax. An injection around the eye to temporarily stop you from moving the eye may also be given.
  3. The surgeon will clean the eye and the area around it. The eyelids will be held open with a lid speculum tool.
  4. The surgeon will make a small incision in the eye and a lubricant will be placed to protect the cornea.
  5. The ICL will be placed through the incision. The ICL lens is very thin, so it might be folded then unfolds when in the eye.
  6. The surgeon will then check the ICL is correctly positioned and remove the lubricant. Depending on the incision, they might close the opening with small stitches.
  7. Eye drops or ointment will be placed in the eye, then covered with an eye patch.

The procedure takes around 20 to 30 minutes. Afterwards, you’ll be taken to a recovery room where you’ll be closely monitored for a few hours.

Eye drops or oral medication for the pain may be prescribed by your eye doctor.

A follow-up appointment will be needed the next day, where the surgeon will examine the eye and check on progress.

Within the next year, follow-up visits at 1 month and 6 months after surgery are necessary. Your eye doctor will also ask you to attend regular checkups once a year to check your vision and the positioning of the ICL.

Limitation of ICLs

While the risks of the implantable contact lens are very low it is important to know its limitations.

Not for Everyone – The ICL is primarily meant for those in the 18-50 age group since before 18 they are still growing and after 50 the eyes may change.

Regular Check-Ups – ICL’s are intended to stay in place indefinitely. However, it is still recommended to have regular appointments to ensure that the implants are functioning properly and in the correct position.

Insurance Coverage is Unlikely – An ICL is considered a cosmetic procedure making it most likely not be covered by most insurance plans. An ICL is custom made for each individual, making it more expensive per eye than LASIK.

Possible risks

Even though ICL surgery has been shown to be safe, it may cause an increased risk for other eye conditions such as:

  • Early cataracts – A decrease in the circulation of fluid in the eye, which causes cataracts, can occur because of the ICL or if it was not sized properly.
  • Glaucoma – An oversized or incorrectly positioned ICL can increase pressure in the eye leading to glaucoma.
  • Vision loss –  Vision loss may occur if there is high eye pressure for for extended periods of time
  • Blurry vision –  If the ICL is not the right power blurry vision may occur. This is also a symptom of cataracts and glaucoma. Other visual problems that may be experienced are double vision or a glare.
  • Cloudy cornea – Sometimes, cells in the cornea are damaged, as a result from eye surgery. If this happens a cloudy cornea and vision loss may occur.
  • Eye infection – While an internal eye infection is a very unlikely side effect, it can result in permanent vision loss.
  • Retinal detachment – Eye surgery increases the risk of retinal detachment. This complication is rare, but requires immediate attention.
  • Additional surgery – Another surgery may be needed to remove the lens to correct related issues.

Post ICL Surgery

After ICL surgery most people experience only minimal discomfort and are able to go back to work within a few days after the procedure. Eye drops will need to be taken for a period of 2 weeks after the surgery. It is important to take them as instructed by the surgeon to ensure the best possible outcome.

Following ICL surgery, people usually see better than they ever did with glasses and can enjoy the activities that were not possible because of their high prescription.

Surgery can be nerve-racking, but be reassured that the ICL process is done as efficiently and smoothly as possible. ICL is just another advanced surgery option to treat and improve vision.

If you are currently looking into ICL, contact an eye doctor near you to schedule an appointment, they can discuss in more detail about ICLs, to help you make a more informed decision.