Implantable Collamer Lenses at a Glance

Implantable Collamer Lenses (ICL) are a vision correction option for those patients who want to see well without relying on glasses and contacts. ICLs, or phakic intraocular lenses (IOL), are clear lenses that work within the eye to focus vision, rather than on the surface of the eye like a contact lens.  ICLs offer permanent vision correction without additional maintenance apart from annual eye exams. However, if necessary, implantable collamer lenses can be surgically removed.


What vision problems do Implantable Collamer Lenses treat?

ICLs and phakic IOLs treats a broad range of nearsightedness prescriptions.  Some implantable lens technologies can also treat additional astigmatism. ICLs can treat prescriptions in the following ranges:

  • Nearsightedness (myopia) from -3D to -20 D
  • Astigmatism from 1.0 D to 4.0 D

What happens in the ICL procedure?

After numbing the eye and gently inserting an instrument to keep the eyelids open, a tiny incision, between 3 and 6 mm, is made in the surface of the eye. More advanced Implantable Lens technology, such as the biocompatible EVO Implantable Collamer Lens, is typically done with smaller incisions that do not require any stitches. Through this incision, the surgeon inserts the implantable lens behind the pupil. The entire procedure takes approximately 20 minutes, and most people immediately see better with vision improving over the next few days and up to four weeks during the healing process.

Does Implantable Collamer Lens surgery hurt?

Numbing eye drops are used and you will likely be offered some medication to help calm your nerves to keep you comfortable during the procedure. After the surgery, the typical experience is some minimal discomfort. Patients report itchiness or a feeling like something is in your eye after the numbing drops wear off. You may be instructed to use over-the-counter pain relievers to help with any mild symptoms. However, you should inform your eye doctor of any significant pain or other bothersome symptoms.

Are you awake during ICL surgery?

Yes, patients are awake during ICL surgery. However, the numbing drops and anti-anxiety medication prescribed are designed to make the experience as comfortable and painless as possible. In this way, it is similar to a LASIK experience.  The ICL procedure is performed in a sterile surgical room with draping over the patient face.  An eyelid holder is used helps keep the lids open and lashes back so patients don’t have to worry about involuntary blinking.  Patients are asked to look into a bright light, which can seem intense, but isn’t painful.  Having patients focus this way helps keep the eye still during the procedure.

How effective are ICLs?

The FDA clinical trial followed 327 patients with either the EVO/EVO+ Visian Implantable Collamer Lens or the EVO/EVO+ Visian TORIC Implantable Collamer Lens.  An evaluation of the clinical trial data ( found:

  • At 6 months post op, 98.5% of patients achieved the same or better vision than they had with their glasses or contact lenses.
  • At 6 months post op, more than 52% of patients had better vision (one or more lines on the Snellen chart) than they had with their glasses or contact lenses.
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How do I find out if I’m a good candidate?

There are certain eye measurements your eye surgeon will take as part of your consultation to determine if you are a candidate for Implantable Collamer Lenses.  Additionally, candidates for Implantable Lenses meet the following eligibility requirements:

Patients 21-45 years of age with healthy eyes and a stable vision prescription for approximately one year within the following prescription ranges are likely candidates for EVO ICL procedures:

  • Correction of myopia with EVO ICLs can be achieved for prescriptions ranging from -3.0 D to less than -15 D with less than 2.5 D of astigmatism.
  • Reduction of visual impairment can be achieved for those patients with myopia prescriptions between -15 D and -20 D with less than 2.5 D of astigmatism.

Patients who have been told they are not eligible for laser vision correction procedures such as LASIK and PRK because the prescription is too strong, or the condition of their cornea is too poor, may otherwise be suitable candidates for ICLs.

Patients who are not suitable for ICLs include:

  • Those who are pregnant or nursing
  • Those with chronic, degenerative, or auto immune diseases such as rheumatoid arthritis or diabetes and certain medications (steroids, immunosuppressants) that may interfere with the healing process
  • Those not in the eligible age range (between 21-45 years old)
  • Those with eye anatomy or shape that cannot accommodate an ICL

Are Implantable Collamer Lenses safe?

The FDA clinical investigation into ICL safety showed that serious sight-threatening complications from the procedure are incredibly rare with less than 1 percent of procedures resulting in vision loss of two or more lines on a Snellen Chart.

What are the risks?

ICL surgery is safe and effective for those who are good candidates. Surgeons closely monitor Implantable Lens patients during the recovery and healing process. In particular, the pressure in the eye is measured repeatedly to protect against vision loss due to glaucoma or cataracts.  As with all surgery, there is the risk of rare complications including infection, retinal detachment or loss of corneal cells which can lead to vision loss.  However, unlike many forms of vision correction, ICLs can be surgically removed to assist in addressing any issues.

How do I prepare for ICL surgery?

If you wear contacts, your surgeon will ask you to stop wearing them for a week or so before the surgery. In addition, you may be asked to come in for a surgical prep appointment 2 – 3 weeks in advance. At this in-office visit, a small opening at the edge of the iris is created to help eye fluid circulate and maintain an appropriate pressure in the eye after the procedure. Eyedrop medication is also prescribed to prepare your eyes for surgery.

Although patients to go home the same day as the procedure, depending upon when the surgery is schedule you may need to take a day or two off work. In addition, you will need to arrange for a ride home from the Implantable Lens procedure.

What is recovery like?

Patients go home the same day as the ICL procedure.  Your eye surgeon will put an eye shield on your face to protect the eye for a day or two.  There are routine eye drops to prevent infection, reduce inflammation, and support the healing process.  Patients are instructed to avoid rubbing or touching their eyes, as well as avoid lifting anything heavy or doing anything too strenuous until the eyes are healed.

Most patients see better immediately after surgery, but it isn’t unusual for vision to be hazy or blurry. Some patients are more sensitive to light in the first couple of days. While most people can return to work and drive again after a couple of days, it can take a few weeks to recover and completely heal from the ICL procedure.

Importantly, there will be a few follow up appointments with your eye surgeon during the recovery and healing phase. As healing progresses, your eye surgeon will let you know which activities you can add back into your routine, such as weigh lifting and other strenuous exercise.

How much does ICL surgery cost?

On average patients can expect to pay between $4,000 – $6,000 per eye for the most advanced implantable lens procedure. Pricing depends on several factors including whether the procedure is performed at the surgeon’s practice or surgery center. Most practices offer payment plans that run about $200 a month.

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