- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: December 7, 2024
- Last Updated: October 8, 2026
TL;DR: If you develop cataracts after ICL surgery, your implantable collamer lens (ICL) is removed and the cataract is treated, usually in a single operation. A new lens implant replaces your natural lens, and its power is chosen to correct your prescription, so many patients see as well as they did with the ICL, or better.
Outcomes of this combined operation are good.¹
At Blue Fin Vision®, its price is published before you ever have your ICL.
A plan for later life is part of the operation you choose today.
Treating Cataracts After ICL Surgery
The operation involves three main steps:
- Through a small incision, the ICL is carefully removed.
- The cloudy natural lens is removed with ultrasound, exactly as in standard cataract surgery.
- A new intraocular lens, an artificial lens implant, is placed in the lens capsule, the thin membrane that held your natural lens.¹
The new implant corrects your short-sightedness. A toric implant, a lens designed to correct astigmatism, can also address blurred vision caused by an uneven curvature of the cornea, the clear front surface of your eye. You do not need the ICL any more.
What the Evidence Shows
The largest multicentre study of combined ICL removal and cataract surgery included 83 eyes at five centres. Patients were around 50 years old on average and had long, highly short-sighted eyes.¹
The most common cataract type was anterior subcapsular cataract, clouding just beneath the front of the natural lens capsule. This is the form associated with ICLs. Both uncorrected and corrected vision, meaning vision without and with glasses or other correction, improved significantly after surgery.¹
Cataracts after ICL surgery tend to appear earlier in people who had their ICL implanted later in life, and were more frequent with older lens designs.² ³
Modern central-port lenses, which have a small central opening to allow fluid to flow through, report lower rates.⁴
The characteristic early change sits on the front surface of the natural lens, where the ICL is closest.⁵ This is why it is examined at every monitoring visit.
Why This Surgery Needs Particular Care
- Measurement. Lens-power calculation in long, highly short-sighted eyes needs careful biometry, measurements used to calculate the replacement lens power, that allows for the ICL in the eye.¹
- The cornea. Your endothelial cell count, a measurement of the cells lining the inner surface of the cornea that help keep it clear, is recorded throughout monitoring. It helps plan the safest approach.
- The retina. Highly short-sighted eyes have a higher background risk of retinal problems, including retinal detachment, where the light-sensitive layer at the back of the eye pulls away from its normal position.⁶ Blue Fin Vision® has its own in-house vitreoretinal service, providing specialist care for the retina and the gel inside the eye, so specialist retinal care stays within the same team.
Why Your Eye Clinic Matters for Long-Term Care
The financial cover is only half of the commitment. The other half is continuity with your eye clinic.
If a cataract develops, you return to a team that already holds your ICL size, your vault history, your endothelial cell counts and your prescription over the years. Your vault history records the gap between the ICL and your natural lens.
The same team removes the ICL, performs the cataract surgery and chooses the replacement implant with biometry that allows for the ICL. It also assesses the retina through our in-house vitreoretinal service.
Nothing has to be reconstructed from memory or from another clinic’s records.
The Blue Fin Vision® Post-ICL Cataract Surgery Pathway
The pathway is defined in the ICL Lifetime Monitoring Protocol™ and priced in advance. The cost of cataract surgery per eye depends on the time since ICL implantation:
- Up to 2 years: No charge.
- 2 to 10 years: 50% of our standard fixed cataract surgery price.
- After 10 years: Our standard fixed cataract surgery price.
The pathway includes:
- The pre-operative consultation
- Biometry and planning
- ICL removal
- Cataract surgery
- A standard monofocal lens implant, which focuses vision at one distance, or a toric lens implant to correct astigmatism
- All routine post-operative care
Premium lenses are available as an optional upgrade. These include trifocal implants, which provide focus at near, intermediate and distance ranges, and extended depth of focus implants, which provide a broader continuous range of focus.
If monitoring identifies a developing cataract, you move into the pathway directly, with no external referral.
Further Reading:
- Our cataract surgery information explains the treatment.
- The ICL surgery checklist asks every provider what happens at this stage.
References
- Kamiya K, Shimizu K, Kitazawa Y, Kojima T, Nakamura T, Ichikawa K, et al.; Japan ICL Study Group. A multicenter study on clinical outcomes of simultaneous implantable collamer lens removal and phacoemulsification with intraocular lens implantation in eyes developing cataract. Ophthalmol Ther. 2025;14(2):337-50. doi:10.1007/s40123-024-01078-8.
- Guber I, Mouvet V, Bergin C, Perritaz S, Othenin-Girard P, Majo F. Clinical outcomes and cataract formation rates in eyes 10 years after posterior phakic lens implantation for myopia. JAMA Ophthalmol. 2016;134(5):487-94.
- Choi JH, Lim DH, Nam SW, Yang CM, Chung ES, Chung TY. Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia. J Cataract Refract Surg. 2019;45(11):1555-61. doi:10.1016/j.jcrs.2019.06.015. PMID:31587936.
- 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.
- 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):765-76. doi:10.3928/1081597X-20110617-01.
- NHS. Detached retina (retinal detachment) [Internet]. NHS; 2023 Aug 4 [cited 2026 Oct 6].
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)
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