Implantable Collamer Lens (ICL) Surgery

Implantable Collamer® Lens (ICL) surgery means that a lens implant in your eye goes between your iris and your natural lens. It can treat refractive errors, so you’ll no longer need contact lenses or glasses. Your surgeon will need to examine you and measure your eyes to see if you’re eligible for ICL surgery.

Overview

An implantable collamer lens sits between your iris and the natural lens in your eye.
An implantable collamer lens (ICL) surgery treats poor eyesight from refractive errors by putting an ICL in between your natural lens and your iris.

What is Implantable Collamer Lens (ICL) surgery?

ICL surgery is a procedure that treats poor eyesight from refractive errors by implanting a Collamer® lens into your eye. This surgery may be possible for people who don’t meet the criteria for LASIK surgery.

A Collamer lens combines plastic and collagen to create a more natural and flexible lens. These lenses are lighter than other types of lenses and hydrophilic (they can mix with water and become wet). A Collamer lens is better than some other types of lenses at letting gas and nutrients pass through.

Your surgeon will place the implanted lens behind your iris and in front of your natural lens.

Earlier versions of the implantable lens called for a surgeon to perform a laser iridotomy before the ICL surgery. Your surgeon would make one or two tiny holes in your iris. This would help prevent pressure from building up when they implanted the lens into your eye. The tiny holes allow for proper drainage of aqueous fluid.

Now, there’s the EVO Implantable Collamer Lens, which comes with a tiny hole in the middle of the lens. This hole makes laser iridotomy unnecessary. Fluids can flow naturally through the hole.

What does an Implantable Collamer Lens surgery treat?

You might have an ICL surgery if you have these refractive errors:

How common is this procedure?

Surgeons have performed an estimated 500,000 ICL procedures throughout the world, using about 1 million lenses.

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Procedure Details

How should I prepare for an Implantable Collamer Lens surgery?

Before you have this surgery, your eye care specialist will do an eye exam, take a medical history and ask you about any medications you normally take.

To be a candidate, you should:

  • Have a stable prescription (the same for about a year).
  • Be between 22 years old and 45 years old.
  • Have eyes that meet certain criteria in terms of shape, anterior angle and thickness of cells on your cornea. The anterior chamber angle in your eye is located between your cornea and iris. Its size influences how quickly aqueous fluid flows out of your eye.

Your provider will tell you how to prepare for the surgery, like if or when you should stop eating or drinking, or if you should stop taking any type of medication before the procedure.

You’ll need to have an adult friend or family member drive you to and from the surgery.

Before the surgery, your surgeon will dilate and numb your eyes with medicated eye drops. Your provider may also give you a mild sedative to help you stay calm and relaxed.

What happens during an Implantable Collamer Lens (ICL) surgery?

After dilating and numbing your eyes, your surgeon will make a very small incision at the base of your cornea. They’ll fold and insert the implantable lens into the cut and then adjust it behind your iris and in front of your lens. You probably won’t need stitches because the incision is so small and will heal on its own.

How long does an Implantable Collamer Lens (ICL) surgery take?

This surgery typically takes less than 30 minutes for both eyes. (You usually have this surgery done on both eyes at once.)

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What happens after Implantable Collamer Lens (ICL) surgery?

After the surgery, your surgeon will give you instructions about what you need to do or what to avoid. You’ll have eye drops to keep your eyes clean and to prevent infection. You may need to use these drops for about two weeks.

Your designated driver will take you home after the surgery.

Your eyesight may improve within 24 hours, possibly even right away, and may continue to improve over the next two to three days.

Risks / Benefits

What are the benefits of an Implantable Collamer Lens (ICL) surgery?

There are many benefits to ICL surgery. These may include:

  • You may be able to have ICL surgery even if you’re not able to have other types of eye surgery, like LASIK.
  • You may be able to see really well right away, without glasses or contact lenses.
  • The effects should last for a very long time, even for the rest of your life.
  • If you needed to have the surgery reversed, you could. There’s no structural damage to your eye.
  • You’re at less risk for dry eye.
  • You may have really good night vision.

How successful is Implantable Collamer Lens (ICL) surgery?

Some research indicates that nearly 95% of the people who have this surgery are satisfied or very satisfied with the results.

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What are the risks or complications of Implantable Collamer Lens (ICL) surgery?

Any type of surgery carries risks. Risks or complications of ICL surgery include:

  • Bleeding.
  • Infection.
  • Inflammation inside the eye.
  • Seeing halos or glare.
  • Having a higher eye pressure. (This usually gets better on its own.)
  • Sensitivity to light. (This also usually gets better on its own.)

You might need to have the lens removed if you have a change of prescription or if you develop cataracts.

Recovery and Outlook

What is the recovery time?

Within a few days, you should recover completely and be able to return to most regular activities. Complete visual improvement may take a week to 10 days.

Ask your provider specific questions about things you should or shouldn’t do, like taking a shower, driving or going back to work or school.

You’ll probably need to use your medicated eye drops for a few weeks. Ask your provider about how long you need to do this.

Your provider will want you to return for appointments:

  • The next day.
  • After one week.
  • After three months.
  • On a recommended schedule.

This schedule may vary among providers.

When To Call the Doctor

When should I call my healthcare provider?

Your surgeon will probably send you home with a specific list of situations that you should make a phone call about or go to an emergency room for. This may include:

  • Excessive pain.
  • Excessive bleeding.
  • Signs of infection, like discharge from your eye or developing a fever.
  • Sudden loss of vision.

You should be able to call your provider’s office with any type of question after your procedure. You should always feel free to ask for clarification.

Additional Details

How much does it cost to have Implantable Collamer Lens (ICL) surgery?

Many insurance companies don’t pay for elective surgery like ICL surgery, but you should contact your insurer before the procedure just to be clear on what they will or won’t cover.

Some research indicates that ICL surgery costs about $4,000 per eye, but the cost will vary depending on where you’re located and which surgeon you use.

What’s the difference: LASIK vs Implantable Collamer Lens (ICL) surgery?

LASIK and ICL surgery are similar in what they try to achieve — decent vision without glasses or contact lenses. The procedures differ in how they achieve the results, but both are very safe and provide reliable results.

LASIK surgery has had government approval in the U.S. for longer than ICL surgery has.

LASIK uses lasers to reshape your cornea to improve the way that light hits your retina. ICL puts a new lens in between your lens and your iris but doesn’t change the structure of your eye.

LASIK treats the same conditions that ICL surgery treats. However, ICL can treat people who have a higher degree of nearsightedness than LASIK can.

LASIK may cost less than ICL surgery.

A note from Cleveland Clinic

If you want to stop wearing glasses or contact lenses to have good vision, you may want to contact an eye care provider to discuss surgery. Your provider will assess you and let you know whether you’d be a good candidate for Implantable Collamer Lens surgery. If you decide to have the surgery, make sure you have honest communication with your surgeon and get answers to all your questions. ICL surgery is typically quite safe. People who’ve had the surgery tend to be happy with their results.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 06/05/2023.

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