A proportion of patients will have residual refractive error following ICL implantation. This is not a failure – it reflects the natural limits of lens power calculation in individual eyes, minor sizing variability, and in some cases the presence of pre-existing corneal irregularity that is incompletely corrected by the implant alone. Enhancement by laser eye surgery applied to the corneal surface above an in-situ ICL is a well-established and effective strategy for addressing residual ametropia. ¹ ²
The clinical question that flows from this is straightforward: does the centre performing your ICL surgery have in-house laser capability, or would enhancement require referral elsewhere? The distinction matters because continuity of clinical responsibility is not a convenience – it is a safety parameter. A different surgeon, at a different centre, who has not seen the pre-operative biometry, the operative notes, or the post-operative vault measurements is operating with incomplete information when making enhancement decisions. ³
At Blue Fin Vision®, the same consultant who performs ICL surgery also performs any subsequent laser enhancement. The pre-operative dataset – corneal topography, ECC, anterior chamber measurements, and refractive history – remains within the same clinical record. Enhancement decisions are made by the surgeon who has complete knowledge of the eye, not by a colleague working from a referral letter. In-house laser capability is not a feature to be advertised – it is a clinical standard that ICL patients should require.
References
- Ganesh S, Brar S. Clinical outcomes of phakic intraocular lens implantation for the correction of high myopia with three years of follow-up. Clin Ophthalmol. 2013;7:2011–2021. PMID: 24204123.
- Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016;10:1059–1077. PMID: 27390517.
- Fernandes P, González-Méijome JM, Madrid-Costa D, Ferrer-Blasco T, Jorge J, Montés-Micó R. Implantable collamer posterior chamber intraocular lenses: a review of potential complications. J Refract Surg. 2011;27(10):765–776. PMID: 21610721.
Related Topics
- ICL Surgery Checklist
- Are You on the GMC Specialist Register for Ophthalmology?
- Does Your Surgeon Hold the CertLRS Qualification?
- How Many ICL Procedures Has Your Surgeon Performed?
- Can You Show Me Your Refractive Outcome Data?
- Is Surgery Performed in a Proper Hospital Theatre with Laminar Airflow?
- What Is My Pre-Operative Endothelial Cell Count?
- How Often Will ECC and Vault Be Monitored, and Is This Included?
- What Vault Are You Targeting?
- Does the Clinic Have Access to Laser Eye Surgery for Enhancement?
- Which ICL System and Calculator Do You Use?
- What Happens If I Develop a Cataract Within Two Years?
- What Is the Arrangement If Cataract Develops Between Two and Ten Years?
- Have You Performed Cataract Surgery in an Eye with an Existing ICL?
- How Do You Manage Biometry Calculations in Post-ICL Eyes?
- What Happens If My Myopia Continues to Progress?
- At What Level Would Enhancement Be Considered?
- When After Surgery Would Enhancement Be Performed?
- Who Performs the Enhancement – the Same Consultant?
- Is Laser Enhancement Included in the Price?
- Is Sedation Available, and What Does It Cost?
- Is Oral Diazepam Available for Anxious Patients?
- What Is the Minimum Stay Required Near the Clinic?
- Will You Identify a Named Local Ophthalmologist Before Surgery?
- How Will Annual Vault and ECC Monitoring Be Arranged If I Live Far Away?
