When a patient with an ICL later requires cataract surgery – whether from ICL-related lens opacification or natural age-related change – the biometric calculation for the new intraocular lens cannot be performed using standard methods alone. The presence of a prior intraocular implant alters the effective refractive state of the eye in ways that standard formulas do not account for without modification. ¹
Modern post-refractive biometry uses swept-source OCT platforms, such as the IOLMaster 700, to obtain direct measurement of axial length, anterior chamber depth, and lens thickness. These measurements are combined with validated post-refractive formulas, including the Barrett True-K and Haigis-L variants, which use the patient’s refractive history to correct the effective corneal power estimate and produce an accurate intraocular lens power calculation. ²
In eyes with a history of both ICL implantation and subsequent laser enhancement, the calculation becomes more complex still – the corneal power has been altered by laser, and the pre-operative refraction used for ICL sizing is no longer equivalent to the pre-laser baseline. Reliable IOL power calculation in this context requires full access to the original pre-operative dataset. ³
At Blue Fin Vision®, this complete dataset is maintained within a single clinical record for every patient. When cataract surgery follows an earlier ICL procedure – with or without intervening laser – the biometry is performed with the full refractive history available. That continuity of data is one of the structural advantages of a single-consultant practice that owns every stage of the patient’s refractive pathway.
References
- Kohnen T, Maxwell WA, Holland S, Tetz M. Intraocular collamer lens for high myopia: results from the ICL in Treatment of Myopia (ITM) study. Ophthalmology. 2008;115(8):1392–1400. PMID: 18359068.
- Sanders DR. Anterior subcapsular opacification with the implantable contact lens. J Refract Surg. 2003;19(4):415–422. PMID: 12916486.
- Kamiya K, Shimizu K, Igarashi A, Komatsu M. Four-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia. Arch Ophthalmol. 2009;127(7):845–850. PMID: 19597104.
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?
