- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: August 11, 2026
- Last Updated: August 11, 2026
TL;DR: There is no official league table that can objectively identify a single “best” ICL surgeon in the UK. And I would be cautious about any surgeon or clinic whose main evidence for being the best is simply that their own website says so.
What you can do is evaluate ICL surgeons against evidence you can interrogate, and for the ICL the criteria are unusually specific, because an ICL is not an event but a decades-long relationship. The right questions cover the depth of the assessment, sizing and vault judgement, endothelial safety, toric planning, current volume, the breadth to recommend laser or lens surgery or nothing at all, a written enhancement position, structured lifetime monitoring, removal and exchange capability, and a written plan for the possibility, often decades away, that cataract surgery one day replaces the ICL. Our ICL Surgery Checklist turns those criteria into questions you can take to any surgeon, including me.
Measured against those criteria, I believe I have a strong case to be considered among the UK’s leading ICL surgeons. But I would rather show you the evidence and let you reach that conclusion yourself.
What Does "Best ICL Surgeon" Actually Mean?
An Implantable Collamer Lens is a soft phakic lens placed in the posterior chamber of the eye, behind the iris and in front of your natural crystalline lens, which stays in place and keeps working. Modern designs incorporate a central port that allows the eye’s own fluid to circulate through the lens. The ICL corrects vision without removing corneal tissue, which makes it an important alternative for many patients in whom corneal laser treatment is less attractive, particularly higher myopia or corneal parameters that constrain safe ablation.¹ Ocular surface disease also enters the decision, although an ICL should not be presented as a treatment for dry eye itself. Its published record for effectiveness and safety, from the original FDA trial through to modern central-port reviews, is strong.² ³ ⁴
But the underlying ICL technology is standardised; what varies is the surgeon. Being the best ICL surgeon therefore means excelling at three different time horizons at once: the decision, the operation, and the decades. Most marketing covers only the second, and briefly.
1. The Decision: What a Serious ICL Assessment Looks Like
The most consequential part of ICL surgery happens before any lens is ordered, in the assessment, and you can judge an ICL surgeon by its depth. A serious assessment establishes at least four things.
That your prescription is stable and your eye healthy. An ICL corrects the refraction you have; a still-changing prescription undermines the plan, and co-existing eye disease may change the recommendation entirely.
Your internal anatomy, measured, not estimated. Sizing an ICL requires knowing the dimensions of the space it will occupy. That means anterior segment measurement of the structures behind the iris, not an external glance. Ask what is measured, with what technology, and how those numbers become a lens size.
Your endothelial baseline. The corneal endothelium, the single layer of cells that keeps your cornea clear, has very limited regenerative capacity in vivo, which is why endothelial cell density matters before implantation and during long-term follow-up. A baseline count belongs in your record before surgery, because the published safety profile of modern central-port designs² is an average, and a published average is not your eye. Measurement is.
Whether the ICL is actually your best option. A suitable cornea may make laser the better answer; an ageing lens in the late 40s or 50s may make lens replacement the honest one;⁵ and sometimes the right advice is to keep your glasses. A practice that offers only ICL has fewer alternative refractive pathways available when ICL is not the best solution. Because my practice spans laser, ICL and lens surgery, the recommendation can follow the eye rather than being constrained by a single treatment modality.
2. The Operation: Sizing, Vault, Toric Planning and the Hands
Sizing and vault. The ICL must be sized to your eye’s internal anatomy so that it sits with an appropriate vault, the clearance between the back of the ICL and the front of your natural lens. Sizing and the resulting postoperative vault are among the most important technical considerations in the entire procedure. A vault that is too low brings the ICL close to the natural lens; a vault that is too high can crowd the drainage structures at the front of the eye. The clinical significance of an unusually low or high vault depends on its degree and what is happening elsewhere in the eye, including the natural lens, anterior chamber angle and intraocular pressure. This is why vault is measured rather than assumed, and why it remains relevant beyond the first postoperative visit: vault is not fixed for life, and long-term follow-up shows it can change gradually over the years.⁶
Toric planning. Many ICL patients also have astigmatism, and the toric ICL corrects it within the same implant. The United States FDA trial of the toric ICL, reported by Donald Sanders, David Schneider, Robert Martin, David Brown, David Dulaney, John Vukich, Stephen Slade and Steven Schallhorn across 210 eyes, demonstrated effective correction of moderate to high myopic astigmatism.⁷ But a toric lens adds a planning dimension: the correction only works on the intended axis, so precise pre-operative marking and placement matter, and a toric ICL that rotates away from its axis loses effect and may need repositioning.
The hands, and how to weigh experience. Individual surgeon experience is one measurable factor worth interrogating. Large cataract-registry data show capsule complication rates varying substantially with individual surgeon volume, while the volume of the unit itself was not independently associated with complication rate.⁸ Although those are cataract rather than ICL data, the principle is useful: do not assume the reputation or size of the building tells you about the individual who will operate. I have performed more than 57,000 ophthalmic procedures, including over 25,000 in the last four years, across ICL, laser and lens surgery. Volume tells you how much somebody operates. Culture tells you what they do with the results: I publish six consecutive years of audited cataract surgery outcomes, presented for what they are, my intraocular audit rather than an ICL-specific national comparison, because no national ICL league table exists. The measurement culture your ICL inherits is the point, and it is on the record.
3. The Decades: Where ICL Surgeons Really Separate
Most comparisons of ICL surgeons stop at the operation. The ICL does not. It sits in your eye for decades, the vault and endothelium need monitoring across those decades, and the questions that genuinely separate ICL surgeons are the year-twenty ones.
Fine-tuning, occasionally. A symptomatic residual refractive error may, where clinically appropriate, be managed with refractive enhancement, at Blue Fin Vision® fully covered for eligible self-pay ICL patients within 24 months under our written Enhancement Policy, with no cost-sharing.
Exchange, rarely, but with a pathway. The ICL is designed to be removable, one of its genuine virtues, but only if your surgeon is comfortable exercising it. The contemporary evidence is reassuring on frequency: in a recent series from a high-volume United States refractive centre covering 961 EVO ICL eyes, the size-related exchange or explant rate was 1.1%, with toric rotation accounting for six exchanges and five eyes exchanged because of initial vault concerns.⁹ Exchange is uncommon; the provider question is whether an established pathway exists for the patient who needs it. At Blue Fin Vision®, removal and exchange sit inside our own surgical pathway.
Monitoring, for the life of the lens. Vault and endothelial counts are not day-one questions; they are year-five, year-ten and year-twenty questions. The Lifetime Monitoring Protocol™ for ICL patients provides structured lifelong vault and endothelial monitoring at defined intervals within one system, and it exists because a surgeon with no answer beyond “come back if there is a problem” has not built for the operation they sell.
And the destination operation. ICL surgery preserves your natural crystalline lens; it does not stop that lens ageing. Many patients implanted in their 20s, 30s or 40s may therefore eventually require cataract surgery later in life, at which point the ICL can be removed as part of the transition to cataract surgery and an intraocular lens. The important point is not that this is inevitable on a particular timetable. It is that an ICL surgeon should have thought about that future before implanting the lens today, and should ideally be an accomplished lens surgeon in their own right, because the person best placed to plan the far end of an ICL journey is somebody who performs the destination operation for a living. I perform lens and cataract surgery at high volume, the transition is written into the Blue Fin Vision® Advantage, and I know the destination personally: I underwent cataract surgery myself in April 2024 and live with trifocal intraocular lenses in both eyes. When I discuss an ICL patient’s distant future, I am describing an operation I both perform and have received.
The Standard I Would Apply If It Were My Own Family's Eyes
Strip away the marketing and this is the test I would actually use if somebody I love were considering an ICL. I would want the recommendation to come after the measurement, never before it. I would want the surgeon to explain the sizing to me in words I could follow, and to tell me the predicted vault before surgery and the measured vault after it. I would want a baseline endothelial count in the record, and a named schedule for checking it again. I would want the surgeon to be genuinely capable of recommending a different operation, or none. I would want the enhancement terms, the exchange pathway and the cataract transition in writing, dated before any money changed hands. And I would want the person who did the explaining to be the person holding the instruments. None of that is exotic. It is simply rare, and its rarity is the ranking.
The Questions That Separate ICL Surgeons, and the Answers That Should Worry You
- How much ICL surgery do you perform, including removals?
Why it matters: individual surgeon experience is a measurable factor worth interrogating, and removal capability completes the surgical pathway.
Weak answer: years since qualification, no numbers.
Strong answer: current volumes, spanning implantation, exchange and removal.
- How do you size my ICL and plan the vault?
Why it matters: sizing and vault are among the most important technical considerations.
Weak answer: a standard size chosen without being able to explain how your measurements led to it.
Strong answer: a reasoned account of your measurements, sizing method, predicted vault and why that size was selected for your eye.
- What is my baseline endothelial count, and who follows it?
Why it matters: the endothelium has very limited regenerative capacity in vivo.
Weak answer: “We check you are fine before you leave.”
Strong answer: a recorded baseline and monitoring at defined intervals, in writing.
- Can you correct my astigmatism, and what if the lens rotates?
Why it matters: toric effect depends on axis, and rotation loses correction.
Weak answer: “That almost never happens.”
Strong answer: personal toric planning, and a repositioning pathway if needed.
- What if an ICL is not right for me?
Why it matters: a one-operation surgeon needs your eye to fit it.
Weak answer: every assessment ends in an ICL.
Strong answer: laser, lens replacement or no surgery, recommended when they fit better.
- What are your written enhancement terms?
Why it matters: fine-tuning is a recognised part of refractive care, and who pays varies.
Weak answer: terms produced after you need them.
Strong answer: a published policy you can read before paying.
- Who monitors my vault and endothelium in year ten?
Why it matters: the lens is in your eye for decades.
Weak answer: “Come back if there is a problem.”
Strong answer: a structured lifelong protocol at defined intervals.
- If I develop a cataract in later life, what happens?
Why it matters: the ICL is removed as part of the transition to lens surgery.
Weak answer: “That is decades away.”
Strong answer: a written plan, within the system that implanted the lens.
- Who performs my operation?
Why it matters: reputation should belong to the hands that operate.
Weak answer: uncertainty about who will perform the procedure, or a different surgeon from the one whose experience informed your decision.
Strong answer: the surgeon you selected.
These questions are available as our ICL Surgery Checklist. Take it to another surgeon. Ask them the same questions. Then compare the answers, particularly the year-twenty ones.
How Does Mr Mfazo Hove Measure Against Those Criteria?
- More than 57,000 ophthalmic procedures, including over 25,000 in the last four years, across ICL, laser and lens surgery, with implantation, exchange and removal capability within one pathway.
- CertLRS, 6.5 years of Moorfields training, a research MD and five consultant years at the Western Eye Hospital, Imperial College Healthcare NHS Trust.
- A practice spanning ICL, laser and lens replacement, so the ICL is recommended by suitability, never by default.
- Six consecutive years of published, audited cataract surgery outcomes, the measurement culture the ICL pathway inherits.
- The Lifetime Monitoring Protocol™ for ICL patients, written enhancement coverage and a written ICL-to-cataract transition plan, all inside the Blue Fin Vision® Advantage, with transparent pricing on the ICL costs page.
- Personal experience of the operation that may one day end an ICL’s service: cataract surgery, in April 2024, with trifocal lenses in both of my own eyes since.
There is external recognition too, including more than 550 verified Doctify reviews, Top Recommended status in the Spear’s 500 and inclusion in the Tatler Address Book. It sits alongside the clinical evidence. It does not replace it.
Is the Best ICL Surgeon Necessarily in London?
No. Geography is convenient; it is not a clinical outcome, and patients travel to us from across the UK. I would choose the surgeon and the assessment process first, then ask how far you need to travel. For patients in and around the capital, the location-specific question is answered in Who Is the Best ICL Surgeon in London?, and the provider-level test in Best ICL Surgery UK
So, Who Is the Best ICL Surgeon in the UK?
No league table can crown one name. But the ICL rewards a particular kind of surgeon: one who measures before recommending, can explain sizing and vault in plain words, records and follows the endothelium, plans toric axes and can handle a rotation, offers more than one operation, publishes an audit culture, and answers the year-twenty questions in writing today. On those measures I am comfortable asking you to compare my practice with any ICL service in the UK.
The best ICL surgeon is not simply the surgeon who tells you they are the best. It is the surgeon whose plan for your eye still exists in twenty years.
References
- Randleman JB, Woodward M, Lynn MJ, Stulting RD. Risk assessment for ectasia after corneal refractive surgery. Ophthalmology. 2008;115(1):37-50. PMID: 17624434.
- Packer M. The Implantable Collamer Lens with a central port design: review of the literature. Clin Ophthalmol. 2018;12:2427-2438. PMID: 30568421.
- Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016;10:1059-1077. PMID: 27354760.
- Sanders DR, Doney K, Poco M; ICL in Treatment of Myopia Study Group. United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up. Ophthalmology. 2004;111(9):1683-1692. PMID: 15350323.
- Maldonado MJ, de Salazar Campos A, Castro Machado A. Indications and risk factors in refractive lens exchange: outcomes and special cases (extremes hyperopes and myopes). Arch Soc Esp Oftalmol (Engl Ed). 2026. PMID: 42476410.
- Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg. 2024;50(5):441-447. doi:10.1097/j.jcrs.0000000000001379. PMID: 38085219.
- Sanders DR, Schneider D, Martin R, Brown D, Dulaney D, Vukich J, Slade S, Schallhorn S. Toric Implantable Collamer Lens for moderate to high myopic astigmatism. Ophthalmology. 2007;114(1):54-61. PMID: 17198849.
- Zetterberg M, Montan P, Kugelberg M, Nilsson I, Lundström M, Behndig A. Cataract surgery volumes and complications per surgeon and clinical unit: data from the Swedish National Cataract Register 2007 to 2016. Ophthalmology. 2020;127(3):305-314. PMID: 31767438.
- Hirabayashi M, Virdi G, Nasser T, Libfraind L, Zapata EA, Abramson AJ, Parkhurst G. ICL exchanges or explants due to sizing in a United States high volume center. Clin Ophthalmol. 2025;19:2609-2614. doi:10.2147/OPTH.S528280. PMID: 40800717.
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)
Considering ICL Surgery?
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