What Is Implantable Collamer Lens (ICL) Surgery?

If you wear eyeglasses or contact lenses for nearsightedness, you may have heard of a procedure called “implantable collamer lens” (ICL) surgery.

Perhaps a friend or even your eye doctor has talked about it to correct your vision problems. To decide if ICL eye surgery can help you ditch your glasses or contacts for good, here’s what you need to know.

What Is ICL Eye Surgery?

ICL stands for implantable collamer lens. During ICL eye surgery, your eye surgeon inserts a very thin lens into your eye to permanently correct nearsightedness and astigmatism.

Unlike cataract surgery, this procedure doesn’t remove anything from your eye. It is an “additive” procedure because it doesn’t permanently alter the eye. The ICL is removable if you change your mind.

Collamer lenses consist of a blend of natural collagen plus a polymer, which creates a thin, bendable plastic. They are very different than the stiffer lenses used after cataract surgery.

The U.S. Food and Drug Administration (FDA) approved the first implantable collamer lens in 2005. Since then, the FDA has approved newer models of implantable collamer lenses known as EVO ICL.

ICL surgery first became available to consumers in 2006. But ICL surgery is still fairly new compared to laser vision correction surgery. UPMC eye surgeons have performed ICL surgeries for nearly a decade.

Benefits of ICL surgery

The FDA has approved implantable collamer lenses to help reduce or correct:

  • Nearsightedness, or myopia. This is an eye condition that causes blurry distance vision. Nearsightedness can make it difficult to do things like watch TV or drive.
  • Nearsightedness with astigmatism. This is when your cornea has an asymmetrical curvature, which causes vision to blur.

ICL is a good choice for when you want a removable vision correction surgery option.

More than 75% of people who have ICL surgery report 20/20 vision or better in the implanted eye six months after surgery. That’s according to the FDA. Nearly 99% of people report at least 20/32 vision in the implanted eye six months after surgery.

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How Does ICL Eye Surgery Work?

To understand how ICL eye surgery works, it helps to understand how the eye itself works.

First, light passes through the cornea at the front of your eye. Then the lens focuses the light onto the surface of the retina. Your retina is the lining at the back of your eye that collects visual information and sends it along the optic nerve to your brain.

If the light focuses in front of the retina, the image blurs. The term for this is nearsightedness.

Glasses, contact lenses, and ICL can change the way light bends so that it can focus directly on the retina. This clears your blurry vision.

What happens during ICL eye surgery?

Your surgeon will place the collamer lens behind your iris and in front of the natural crystalline lens of your eye. The iris is the colored part of your eye.

ICL surgery is an outpatient procedure. That means you will go home the same day as your surgery and don’t need to stay overnight in the hospital.

The ICL surgery package at the UPMC Vision Institute includes:

  • Surgical pretesting.
  • Surgery on one or both eyes.
  • A year of follow-up care.

The newer ICL lens models (EVO and EVO+) have a small central hole. This enhances procedure safety by allowing the eye’s natural (aqueous) fluid to circulate freely and not get blocked. There’s also a lower risk of cataract formation with the new EVO ICL models.

Who Is a Good Candidate for ICL Surgery?

ICL surgery isn’t for everyone. A good candidate for ICL surgery is:

  • Between the ages of 21 and 45.
  • Has nearsightedness or nearsightedness with astigmatism.
  • Has stable vision and a prescription that hasn’t changed much over the past year.

Who Should Avoid ICL Surgery?

You should not have ICL surgery if:

  • You are younger than 21 years old or older than 45 years old.
  • You are pregnant or nursing.
  • You have moderate to severe glaucoma.
  • Your cornea and eye chamber don’t meet certain shape and measurement requirements.

Your ophthalmologist will give you a detailed eye exam and other tests to determine if ICL surgery is right for you. Your eye doctor will also ask questions about your overall health and medical history. Some medical conditions can affect your recovery and increase your risk of complications.

What to Expect After ICL Eye Surgery?

After ICL eye surgery, you may not experience any issues, or you may experience side effects that will take time to resolve. Either way, your eye care team will follow you closely.

Common side effects

Common side effects after ICL surgery include:
  • Feeling like something is in your eye.
  • Minor eye discomfort.
  • Seeing glare or halos. This is the most common side effect.

ICL surgery recovery time

For most people, these common side effects go away on their own within three months of surgery. For some, it may take longer.

Complications from ICL surgery

ICL surgery is a safe procedure. But no surgery is without risks. Rare complications of ICL surgery during and after surgery include:

  • Cataract formation.
  • Eye inflammation or infection.
  • ICL rotation. This is only a problem if your ICL is a Toric ICL (for correcting astigmatism).
  • Increased intraocular pressure (IOP), which is an increase in fluid pressure inside your eye.
  • Injury to the other delicate structures of the eye during surgery.
  • Secondary glaucoma.

You may need a second surgery to correct some of these problems. Though the visual results of ICL eye surgery are permanent, your eye surgeon can remove or replace the lenses if necessary.

How Does ICL Compare to LASIK?

LASIK stands for laser-assisted in situ keratomileusis. It’s a type of vision correction surgery that uses lasers to sculpt the cornea.

UPMC Vision Institute surgeons have been performing LASIK for more than 25 years. The UPMC Refractive Surgery Center is the longest continuously running laser center in western Pennsylvania.

The blade-free LASIK offered at the UPMC Vision Institute uses pulses of laser light to create a corneal cap. The surgeon can then lift this cap to allow another laser to reshape the corneal tissue. The surgeon then returns this cap to its original position and your vision starts to improve immediately.

Your UPMC Vision Institute refractive surgeon can help you decide which vision correction surgery is right for you.

Implantable Collamer Lens. American Academy of Ophthalmology. EyeWiki. Link.

Patient Information Booklet. Facts You Need to Know About STAAR Surgical's EVO ICL and EVO TICL Surgery. Patient Information Booklet. Link.

What Are Phakic Lenses? U.S. Food and Drug Administration. Link.

Packer M. The Implantable Collamer Lens with a Central Port: Review of the Literature. 2018. Clinical Ophthalmology. Link.

EVO/EVO+ VISIAN Implantable Collamer Lens — P030016/S035. U.S. Food and Drug Administration. Link.

Nearsightedness. National Library of Medicine. MedlinePlus.gov. Link.

Astigmatism. National Library of Medicine. MedlinePlus.gov. Link.

Zhang H, Gong R, Zhang X, Deng Y. Analysis of Perioperative Problems Related to Intraocular Implantable Collamer Lens (ICL) implantation. 2022. International Ophthalmology. Link.

U.S. Food and Drug Administration. Before, During, and After Surgery. Link.

U..S. Food and Drug Administration. LASIK. Link.

About UPMC Vision Institute

The UPMC Vision Institute is a national leader in the treatment of eye diseases and disorders. We seek to improve and restore your vision to help your quality of life, diagnosing and treating a wide range of conditions in both children and adults. Our treatments include both surgical and nonsurgical options. We also offer routine eye screenings and have full-scale optical shops. Find an eye expert close to you.