- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: December 24, 2024
- Last Updated: October 13, 2026
TL;DR: Both same-day bilateral ICL surgery and treatment one eye at a time can be safe, with the choice depending on your measurements, prescription and circumstances. Treating both eyes on the same day as two separate operations gives you one recovery, balanced vision straight away and fewer visits. Treating one eye at a time lets the result in the first eye inform the second and avoids any complication affecting both eyes at once.
Implantable collamer lens surgery, usually shortened to ICL surgery, involves placing a lens inside the eye while keeping your natural lens in place. Same-day ICL surgery is two operations in one session, not one operation on two eyes.
Same-Day Bilateral ICL Surgery
Balanced Vision Immediately
People who need an ICL usually have high prescriptions. After one eye, the two eyes can be very different, which is uncomfortable until the second eye is treated.
One Recovery, Fewer Journeys
One set of early reviews and one period away from work.
The Infection Risk Is Low
Infection inside the eye after ICL surgery occurred at a rate of about 1 in 6,000 implantations in a survey of users.¹ With each eye prepared, draped and operated on as a separate procedure, the chance of both eyes being affected is extremely small.
ICL Surgery One Eye at a Time
Learning From The First Eye
The vault achieved in the first eye, the space between the ICL and your natural lens, can confirm the sizing approach for the second. Sizing methods have become more accurate, but no formula is perfect.²
Early Pressure Changes
A rise in eye pressure is one of the more common early events after ICL surgery, usually from a response to steroid drops, and almost always settles with treatment.³
Treating one eye first means any such response is seen before the second eye is treated.
Individual Eye Measurements
Very high prescriptions, borderline anterior chamber measurements, which assess the space between the cornea and your natural lens, or other eye conditions may favour a staged approach.
Implantable Collamer Lens Surgery Outcomes
Whichever approach is chosen, modern central-port ICLs, which have a small opening that allows fluid to flow through the lens, give stable, predictable results.
A review of 2,904 eyes reported low adverse event rates, meaning complications were uncommon.⁴ Eight-year follow-up of central-port lenses found 93% of eyes within one dioptre, a unit used to measure prescription strength, of the intended prescription.⁵
Blue Fin Vision® Eye Clinic Assessment
At Blue Fin Vision®, your eye clinic consultation considers your measurements, your prescription, the difference between your two eyes and your practical circumstances.
A large difference between your two eyes, for example, favours treating both together. Borderline measurements in one eye favour treating that eye first.
Whichever you choose:
- Each eye is treated as a separate procedure, with its own sterile preparation and instruments.
- Your consultant speaks to you the day after surgery, and both eyes are reviewed at one week, one month, three months and twelve months.
- Both are enrolled for life in the ICL Lifetime Monitoring Protocol™, with vault and endothelial cells, the cells lining the inner surface of the cornea, tracked against each eye’s own baseline measurements.
Before your consultation, read:
- Our ICL recovery page
- The EVO ICL patient guide
- Our ICL surgery checklist
Book a consultant-led ICL surgery consultation with Blue Fin Vision® in London, Hertfordshire, or Essex to discuss whether same-day or staged treatment is suitable for you.
References
- Allan BD, Argeles-Sabate I, Mamalis N. Endophthalmitis rates after implantation of the intraocular Collamer lens: survey of users between 1998 and 2006. J Cataract Refract Surg. 2009;35(4):766-9.
- Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016;10:1059-77. doi:10.2147/OPTH.S111620.
- Senthil S, Choudhari NS, Vaddavalli PK, Murthy S, Reddy JC, Garudadri CS. Etiology and management of raised intraocular pressure following posterior chamber phakic intraocular lens implantation in myopic eyes. PLoS One. 2016;11(11):e0165469. doi:10.1371/journal.pone.0165469.
- Montés-Micó R, Ruiz-Mesa R, Rodríguez-Prats JL, Tañá-Rivero P. Posterior-chamber phakic implantable collamer lenses with a central port: a review. Acta Ophthalmol. 2021;99(3):e288-e301. doi:10.1111/aos.14599.
- 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.
ABOUT THE AUTHOR
Mr Mfazo Hove
MBChB MD FRCOphth CertLRS
Consultant Ophthalmic Surgeon | Founder and Medical Director, Blue Fin Vision®
Mr Mfazo Hove is a Consultant Ophthalmic Surgeon with more than two decades of experience across NHS and private practice and more than 57,000 ophthalmic procedures performed. He trained for six and a half years at Moorfields Eye Hospital and served for five years as an NHS consultant at the Western Eye Hospital, Imperial College Healthcare NHS Trust.
He specialises in cataract surgery, refractive lens replacement, laser vision correction and implantable Collamer lenses (ICL). He is the founder and Medical Director of Blue Fin Vision®, a private ophthalmology group providing consultant-delivered care across London, Hertfordshire and Essex. His cataract surgery outcomes are publicly reported through the National Ophthalmology Database.
A ZEISS Key Opinion Leader and international speaker, Mr Hove is a contributing author to The Ophthalmologist. His writing examines how clinical governance and the organisation of ophthalmic services shape patients’ experiences and outcomes, with a focus on transparent outcome reporting, surgical training and long-term accountability for patient care.
