Implantable Contact Lenses Surgery: Procedure, Recovery and Results

Implantable contact lenses surgery, commonly called ICL surgery, corrects short-sightedness and sometimes astigmatism by placing a thin prescription lens inside the eye without removing the natural lens. It is typically considered for suitable adults who want an alternative to laser vision correction, particularly when their prescription is high or their corneas are not ideal for laser treatment.

Overview: How implantable contact lenses surgery works

Implantable contact lenses surgery is a refractive procedure that uses an implantable collamer lens (ICL), also called a phakic intraocular lens. The lens is positioned inside the eye, usually behind the colored part of the eye (iris) and in front of the natural crystalline lens. It changes the way light focuses on the retina, helping to reduce dependence on glasses or contact lenses.

Unlike laser procedures that reshape the cornea, ICL surgery leaves the corneal tissue largely unchanged. The natural lens also remains in place, so the procedure is not the same as cataract surgery. It is most often used to treat myopia (short-sightedness), including higher prescriptions, and may also correct astigmatism with a toric lens design.

The implanted lens is designed to remain in the eye long term. However, it is not considered irreversible in the same way as tissue-removing surgery: an ophthalmic surgeon can remove or exchange it if this is needed. Suitability and expected results depend on an individual assessment rather than prescription alone.

Who may be a candidate for ICL surgery?

ICL surgery may be an option for adults with a stable glasses prescription who have myopia, with or without astigmatism. It can be particularly helpful for people whose corneas are too thin, irregular or otherwise unsuitable for corneal laser vision correction. A stable prescription for a period determined by the treating ophthalmologist is generally preferred.

Before recommending surgery, the eye specialist measures the cornea, pupil, eye length, prescription and the space between the cornea and natural lens. They also assess the retina, optic nerve and eye pressure. These tests help select the correct lens size and reduce the likelihood of complications.

Not everyone is suitable. Uncontrolled glaucoma, active eye inflammation or infection, certain retinal conditions, cataracts, a shallow anterior chamber, or inadequate endothelial cell counts may make ICL implantation inappropriate or require another approach. People who are pregnant or breastfeeding may be advised to postpone elective refractive surgery because vision can fluctuate during this time.

Other refractive options may be discussed, including laser eye surgery for people with appropriate corneal measurements. The most suitable choice should follow a comprehensive consultation with an ophthalmologist.

Step by step: what happens during the procedure?

Before surgery, the surgeon confirms the treatment plan and may prescribe eye drops to prepare the eye. Modern ICL designs have a small central opening that supports normal fluid circulation within the eye; some patients may still need additional preparation depending on their eye anatomy and the lens selected.

The procedure is generally performed one eye at a time under local anaesthetic eye drops, sometimes with medication to help the person relax. The surgeon makes a very small incision at the edge of the cornea, inserts the folded lens, and gently positions it behind the iris. The lens unfolds in place, and the surgeon checks its alignment and the eye pressure.

The incision is usually self-sealing and typically does not require stitches. The operation itself is commonly brief, but time at the clinic includes preparation, checks after surgery and recovery from any sedative medication. A responsible adult should accompany the patient home if sedation has been used.

Afterward, the patient receives instructions about antibiotic and anti-inflammatory drops, activity limits and follow-up visits. Close early review is important because eye pressure and lens position need to be assessed soon after implantation.

Recovery timeline and daily care

Many people notice clearer vision within the first day or several days after ICL surgery, although vision may initially fluctuate. Mild light sensitivity, watering, a gritty sensation or temporary blurring can occur. The eye needs time to settle, and the final visual result may take several weeks to stabilize.

In the first few days, patients should use prescribed drops exactly as directed, avoid rubbing or pressing on the eye, and protect the eye from water, dust and accidental injury. Eye makeup, swimming pools, hot tubs and contact sports are usually postponed until the surgeon confirms that healing is sufficient. Driving should wait until vision meets legal and practical safety requirements.

Desk-based work may be possible after a short period, depending on comfort and vision, but individual advice varies. Follow-up appointments allow the surgeon to monitor healing, pressure, inflammation and lens position. Long-term eye examinations remain important, even when vision feels excellent.

People considering lens-based procedures later in life should understand that the natural lens can still develop age-related changes. If cataract surgery becomes necessary in the future, the ICL is usually removed as part of surgical planning. Cataract surgery is a separate procedure that replaces a cloudy natural lens with an artificial intraocular lens.

Benefits, limitations and possible risks

A major potential benefit of ICL surgery is meaningful reduction in glasses and contact lens dependence without reshaping the cornea. For appropriate candidates, it may provide high-quality distance vision and can be useful for higher degrees of myopia. Because the natural lens remains, the eye retains its natural focusing ability for near tasks until normal age-related presbyopia develops.

There are limitations as well. ICL surgery does not prevent age-related reading vision changes, cataracts or other eye diseases. Some people may still need glasses for selected tasks, and an enhancement, lens exchange or additional treatment may occasionally be necessary if the prescription changes or the outcome is not as intended.

Potential complications include a temporary or persistent increase in eye pressure, inflammation, glare or halos, endothelial cell loss, lens rotation in toric ICLs, cataract formation, retinal problems and infection. Severe complications are uncommon but can threaten vision, which is why careful screening and scheduled postoperative reviews are essential.

A sudden reduction in vision, increasing pain, pronounced redness, nausea, severe headache, flashes, many new floaters or a curtain-like shadow in vision requires urgent assessment. These symptoms are not expected parts of routine recovery and should not be managed by waiting for a planned appointment.

When to seek medical care

Urgent ophthalmic care is needed after ICL surgery for worsening pain, rapidly declining vision, marked redness, increasing light sensitivity, discharge, vomiting, severe headache, or rainbow-colored halos around lights. These may indicate problems such as high eye pressure, inflammation or infection, which require prompt examination.

Patients should also contact their eye team if they have persistent blurring beyond the expected recovery period, feel that vision has suddenly changed, or notice new flashes, floaters or a dark veil in their sight. People with high myopia have a higher baseline risk of some retinal conditions, so new retinal symptoms should always be evaluated promptly.

For international patients, Acibadem International’s multidisciplinary eye specialists and JCI-accredited hospitals provide assessment and treatment planning for refractive and lens-based eye care. Decisions should be made with a qualified ophthalmologist who can review the individual eye examination and long-term visual needs.

Common questions about ICL surgery

How many days should I rest after an ICL? Most people can return to light daily activities within a few days, provided their surgeon is satisfied with early healing. Rest is most important on the day of surgery and during the first day or two, while strenuous exercise, swimming, eye rubbing and dusty environments should be avoided for the period advised by the surgeon.

What happens if I accidentally bend over after cataract surgery? A brief, accidental bend is unlikely to cause harm in most cases, but patients should avoid repeated deep bending, straining and heavy lifting during early recovery because these activities can temporarily increase pressure in the eye. Cataract surgery recovery instructions are not identical to ICL instructions, so a person should follow the specific restrictions given by their surgeon and contact the clinic if pain or vision changes occur.

What is the downside of ICL surgery? The main downsides are that it is an intraocular operation, requires ongoing monitoring and carries risks such as raised eye pressure, cataract, inflammation, glare, lens rotation and infection. It may also not eliminate the need for glasses in every situation, especially as age-related near-vision changes develop.

What is the success rate of ICL surgery? Studies generally report high levels of predictable refractive correction and patient satisfaction in carefully selected patients. However, success should not be defined by one number: it includes safety, stable vision, lens position, eye pressure and whether the result meets the individual’s visual goals. The surgeon can discuss expected outcomes based on prescription, eye measurements and personal circumstances.

Frequently asked questions

Is implantable contact lenses surgery permanent?

The lens is intended to remain in the eye long term, but it can generally be removed or replaced by an ophthalmic surgeon if medically needed. This differs from laser corneal procedures, which permanently alter corneal tissue. Removal does not guarantee that vision will return exactly to its pre-surgery state, as eye health and prescription can change over time.

Is ICL surgery painful?

The procedure is usually performed with numbing eye drops, so significant pain during surgery is not expected. Some people experience mild irritation, watering or light sensitivity afterward. Increasing pain or marked redness should be reported promptly because it may need urgent assessment.

How long does vision stay blurry after ICL surgery?

Vision can be blurry or fluctuate during the first day or several days as the eye settles. Many people notice rapid improvement, but complete stabilization can take several weeks. Persistent or worsening blur should be discussed with the operating eye team.

Can an ICL be removed later?

Yes, an ICL can usually be removed or exchanged by a qualified ophthalmic surgeon when necessary. Reasons may include a lens-related complication, a significant prescription change or planning for cataract surgery. The decision depends on the eye examination and the reason for removal.

Can ICL surgery correct reading vision?

ICL surgery is mainly designed to correct distance refractive errors such as myopia and astigmatism. It does not stop presbyopia, the normal age-related reduction in near focusing ability. Many adults eventually need reading glasses, even if distance vision is clear after surgery.

Can ICL surgery be done after LASIK?

In some cases, ICL surgery may be considered after previous laser vision correction, but suitability requires careful assessment. The surgeon reviews corneal shape, remaining prescription, internal eye measurements and overall eye health. An individual consultation is necessary because prior procedures can affect treatment planning.

References

• American Academy of Ophthalmology
• U.S. Food and Drug Administration
• Royal College of Ophthalmologists
• European Society of Cataract and Refractive Surgeons

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.