- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: January 3, 2025
- Last Updated: October 15, 2026
TL;DR: Yes, laser eye surgery may be possible after ICL surgery (implantable collamer lens surgery), if your cornea, the clear front surface of your eye, is suitable. This combined approach, known as bioptics, uses laser treatment to fine-tune a small remaining prescription once it has been stable for several months. Most ICL patients never need it, but it is a valuable option when they do.
The ICL does the heavy lifting inside the eye. Laser, where needed, does the fine-tuning on the surface.
Why Laser Eye Surgery After ICL Surgery Works
An ICL corrects most of the prescription from inside the eye. If a small amount of short-sightedness, long-sightedness or astigmatism, an irregular curvature that can blur or distort vision, remains, an excimer laser can reshape the cornea to correct it. This type of laser removes precise amounts of corneal tissue.
Splitting the correction between two planes was first described for extreme short-sightedness, where combining an ICL with LASIK, laser treatment beneath a thin flap in the cornea, corrected prescriptions from −18 to −35 dioptres with good safety. Dioptres are the units used to measure lens power.¹
Later work has shown the approach to be safe and effective for high myopic astigmatism, meaning significant short-sightedness combined with astigmatism, and found that laser treatment did not affect the ICL’s position in the eye.²
How Often It Is Needed
Not often. Modern central-port ICLs, lenses with a small central opening that allows fluid to flow through, are highly accurate: after eight years, 93% of eyes in one long-term study were within one dioptre of the intended prescription.³
For astigmatism, a toric ICL, a lens designed to correct astigmatism, often achieves in one step what would otherwise need an ICL plus laser.⁴
When Laser May Not Be Right
Many people have an ICL precisely because their cornea is thin or irregular, or their prescription is beyond laser’s safe range. The same caution applies afterwards.
If LASIK is not suitable, surface laser treatment, which treats the cornea’s surface rather than beneath a flap, may be. Sometimes the better answer is to reposition or exchange the ICL rather than treat the cornea.
For moderate to high short-sightedness, a Cochrane review of three trials using older technologies found phakic lens implantation, placing an additional lens inside the eye without removing the natural lens, safer than excimer laser as a primary treatment.⁵ This is why the laser’s role after an ICL is refinement, not replacement.
Assessment at Blue Fin Vision® Eye Clinic
Timing. We wait until your prescription has been stable, usually for at least three months, before planning any enhancement.
Assessment first. At our eye clinic, we review corneal tomography, a detailed scan of the cornea’s shape, alongside corneal thickness and your ICL’s vault, the gap between the implanted lens and your natural lens. These checks come before any recommendation. A cornea too thin for laser before the ICL, for example, is usually still too thin afterwards.
In-house laser. Our laser eye surgery service sits within the same consultant-led team, so enhancement does not mean referral elsewhere.
Cost. For eligible self-pay ICL patients, a clinically indicated enhancement within 24 months is provided at no cost to the patient under our written enhancement policy, carried out by your original consultant.
These resources explain your options and help you prepare for your consultation:
- Our article on what happens if your prescription isn’t fully corrected after ICL sets out every option.
- Read our ICL surgery checklist before your consultation.
- Read the EVO ICL patient guide before your consultation.
Book a consultation with Blue Fin Vision® to discuss whether laser eye surgery after ICL surgery is suitable for you. Our consultant-led UK team provides care across London, Hertfordshire and Essex.
References
- Zaldivar R, Davidorf JM, Oscherow S, Ricur G, Piezzi V. Combined posterior chamber phakic intraocular lens and laser in situ keratomileusis: bioptics for extreme myopia. J Refract Surg. 1999;15(3):299-308.
- Moshirfar M, Thomson RJ, West WB Jr, McCabe SE, Sant TM, Shmunes MH, et al. Visual outcomes after sequential posterior chamber phakic IOL with corneal refractive surgery (bioptics) for the treatment of myopic astigmatism. Clin Ophthalmol. 2020;14:4337-46. doi:10.2147/OPTH.S285140. PMID: 33328722.
- Kamiya K, Shimizu K, Takahashi M, Ando W, Hayakawa H, Shoji N. Eight-year outcomes of implantation of posterior chamber phakic intraocular lens with a central port for moderate to high ametropia. Front Med (Lausanne). 2021;8:799078. doi:10.3389/fmed.2021.799078. PMID: 34977099.
- Choi SH, Lee MO, Chung ES, Chung TY. Comparison of the toric implantable collamer lens and bioptics for myopic astigmatism. J Refract Surg. 2011;27(2):91-7. doi:10.3928/1081597X-20100414-01.
- Barsam A, Allan BDS. Excimer laser refractive surgery versus phakic intraocular lenses for the correction of moderate to high myopia. Cochrane Database Syst Rev. 2014;(6):CD007679.
ABOUT THE AUTHOR
Mr Mfazo Hove
Consultant Ophthalmic Surgeon
MBChB MD FRCOphth CertLRS
Mr Mfazo Hove is a Consultant Ophthalmic Surgeon with experience spanning more than 57,000 procedures. He completed 6.5 years of specialist training at Moorfields Eye Hospital and served for five years as a consultant at the Western Eye Hospital, Imperial College Healthcare NHS Trust. He is the founder of Blue Fin Vision®, a consultant-led private ophthalmology practice operating across London, Essex, and Hertfordshire. His clinical expertise encompasses advanced cataract surgery, refractive lens replacement, laser vision correction, and implantable Collamer lenses (ICL).
A ZEISS Key Opinion Leader, Mr Hove is a respected international speaker with five invited engagements across seven cities in 2026:
- ZEISS China tour (Changsha, Shanghai, and Hangzhou, April – ZEISS APAC User Meeting)
- RCOphth Annual Congress – May – Manchester
- ZEISS EMEA User Meeting (Istanbul)
- ZEISS Lausanne User Meeting (Lausanne)
- European Society of Cataract and Refractive Surgeons Annual Congress (ESCRS, London)
