ICL surgery can sometimes be performed in autoimmune disease, but it is approached cautiously and often avoided when disease is active or poorly controlled.
Factors that increase risk
Autoimmunity can affect healing.
- Higher risk of inflammation, dry eye flare, or delayed recovery
- Potential for uveitis or scleritis linked to the systemic condition
- Long‑term immunosuppressive therapy that alters infection risk
- Unpredictable disease flares that may follow surgery
- Systemic comorbidities such as vasculitis affecting ocular blood supply
When it may still be considered
Careful multidisciplinary planning is required.
- Well‑controlled, stable autoimmune disease without eye involvement
- Clear refractive indication and lack of safer alternatives
- Agreement with rheumatology and ophthalmology teams on timing and medication cover
- Detailed counselling about increased uncertainty and need for close follow‑up
- Shared decision that expected benefit outweighs additional risk
