ICL surgery can be considered after corneal cross‑linking once the cornea is stable, particularly in patients with keratoconus and high myopia.
Potential benefits
Combining stability with refractive correction.
- Cross‑linking aims to halt progression, while ICL addresses residual high prescription
- Helps reduce dependence on thick glasses in stable keratoconic eyes
- Avoids further corneal tissue removal after cross‑linking
- May be combined with topography‑guided laser in selected protocols
- Can improve overall functional vision when carefully planned
Key safeguards
Timing and corneal status are critical.
- Evidence of stability on serial topography for at least 6-12 months
- Residual irregular astigmatism may still require rigid or scleral lenses
- Detailed counselling about visual limitations despite refractive correction
- Close collaboration between cornea and refractive specialists
- Long‑term monitoring for both ectasia control and ICL vault
