ICL surgery corrects the refractive error present at the time of treatment, but it does not alter the underlying biology of myopia. In some adults, particularly those with moderate to high myopia, gradual axial elongation of the eye can continue into the 30s and 40s. ¹ As a result, a small degree of refractive drift after ICL surgery is possible, even when the implant itself is functioning perfectly.
For most patients, any change is slow and mild. Vision may soften slightly over years rather than months, and this can often be corrected temporarily with glasses or contact lenses. Importantly, this does not usually indicate that the ICL has failed or needs to be removed.
Where progression matters most is in long-term planning. High myopes carry an increased lifetime risk of retinal pathology, earlier cataract development, and eventual lens-based surgery. ¹ Clinics that monitor refractive stability, axial length, and retinal health over time are better positioned to advise when observation is sufficient and when further intervention should be considered. ²
Understanding that ICL surgery represents one stage in a longer visual journey, rather than a permanent endpoint, helps set realistic expectations and prevents unnecessary concern when small changes occur years later.
References
- Bullimore MA, Brennan NA. Myopia control: why each diopter matters. Optom Vis Sci. 2019;96(6):463–465.
- Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–1042.
Related Topics
- Life After ICL: Why Clear Vision Isn’t the End of the Story
- Can Myopia Still Progress in Adulthood After ICL Surgery, and How Does That Affect Long-Term Vision?
- Why Are Endothelial Cell Counts Monitored After ICL Surgery, and How Often Should They Be Checked?
- What Is ICL Vault, and Why Is It Critical for Protecting the Eye Long Term?
- Is Gradual Vision Change Years After ICL Surgery Normal, and When Should It Be Investigated?
- When Is Laser Enhancement Appropriate After ICL Surgery, and When Is It the Wrong Tool?
- In Your 40s, Is ICL or Lens Replacement More Stable Over the Long Term?
- How Do Modern Clinics Calculate IOL Power Accurately in Eyes That Previously Had ICL Surgery?
- How Accurate and Stable Are Toric Trifocal Lenses After ICL Removal?
- Why Do Two Separate Consultations Improve Safety After ICL?
- Why Should High Myopes Plan Vision Correction Across Decades?
