- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: October 16, 2025
- Last Updated: August 18, 2026
A Title Like This Has to Be Earned on the Page
I did not write headlines like the one above easily, and I remain uncomfortable with surgeons simply declaring themselves the best. So let me treat this title the way I would want any patient to treat it: as a claim requiring evidence. This page sets out that evidence for both halves of my refractive practice, laser vision correction and the Implantable Collamer Lens, and hands each half to the dedicated page where the full case is made.
The Laser Eye Surgeon Evidence
As a laser eye surgeon, I work in a commercial corner of ophthalmology where marketing language runs ahead of credentials, so start with something verifiable: I hold the Royal College of Ophthalmologists’ Certificate in Laser Refractive Surgery (CertLRS), the College’s dedicated examination and certificate in refractive surgery. My laser portfolio spans LASIK, SMILE, PRK, LASEK and PRESBYOND®, because different corneas suit different procedures ⁸ and a surgeon built around one platform has a reason to fit every eye to it.
The evidence for well-selected laser surgery is genuinely strong, with world literature patient satisfaction around 95% ⁶ and modern platform outcomes stronger still. ⁷ The qualifier that matters is well-selected: the most consequential part of laser eye surgery happens before any laser fires, in screening designed to minimise the rare but potentially serious risk of ectasia, ⁵ although no responsible surgeon should imply biological risk can ever be reduced to zero. And the belief is personal as well as professional: the Practice Manager at Blue Fin Vision® has had laser eye surgery herself, performed at Blue Fin Vision®. When someone responsible for running the clinic chooses its own surgical pathway for her own eyes, that makes confidence in the service personal rather than purely corporate.
The full laser evaluation framework, qualification, assessment rigour, procedure range, real accuracy and enhancement numbers, is in Who Is the Best Laser Eye Surgeon in the UK?
The ICL Surgeon Evidence: What Serious ICL Surgery Involves
ICL surgery places a soft Collamer lens inside the eye, in front of the natural lens, correcting 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. ⁵ Its published record for effectiveness and safety, from the original FDA trial through to modern central-port reviews, is strong. ¹ ² ³ But it is unforgiving of casual practice, and the skill sits in five places most advertising never mentions.
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 ICL and your natural lens. Too low brings the ICL close to the natural lens; too high can crowd the drainage structures. The clinical significance of an unusual vault depends on its degree and what is happening elsewhere in the eye, which is why vault is measured rather than assumed, before surgery as a prediction and after it as a fact. Sizing and the resulting postoperative vault are among the most important technical considerations in the entire procedure.
Endothelial Safety
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. Modern central-port designs have a reassuring published safety profile, ¹ but a published average is not your eye. Measurement is.
Toric Planning
Many ICL patients also have astigmatism, corrected within the same implant: the United States FDA trial of the toric ICL demonstrated effective correction of moderate to high myopic astigmatism across 210 eyes. ⁴ But toric correction only works on the intended axis, so planning, placement and a repositioning pathway for the occasional rotated lens all belong to the surgeon’s craft.
Judgement Across the Alternatives
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 replacement, the recommendation can follow the eye rather than being constrained by a single treatment modality: laser where the cornea suits it, ICL where it does not or the prescription is high, lens surgery where the ageing lens is the real problem, ⁹ and no surgery at all where that is the honest answer.
Exchange and Removal Capability
The ICL is designed to be removable, one of its genuine virtues, and the contemporary evidence is reassuring on how rarely that is needed: in a recent high-volume United States series of 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. ¹⁰ 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.
Why ICL Expertise Is Not the Same as Cataract Expertise
It is tempting to assume that a high-volume cataract surgeon is automatically a high-calibre ICL surgeon, because both operations happen inside the eye. The skill sets overlap, and my own cataract volume is exactly why my ICL removal and exchange pathway exists in-house. But elective phakic-lens surgery introduces problems cataract surgery never poses: the natural lens stays, so nothing may touch it; the implant must be sized to anatomy that is measured rather than opened; the patient is usually young, so the plan must survive decades; and the endpoint is not the operation but the surveillance that follows it. An ICL surgeon should be judged on ICL-specific evidence, sizing method, vault record, endothelial follow-up and removal capability, not on intraocular reputation alone. That cuts both ways, including for me.
What I Look At Before Recommending an ICL
Before I recommend an ICL to anybody, I want to know nine things about the eye and the person: the cornea, because a suitable cornea may make laser the better operation; the anterior chamber anatomy, because the ICL must physically fit with an appropriate vault; the endothelium, measured as a baseline count, not assumed; the refraction, for magnitude and, critically, stability; the age, because it shapes both the accommodation conversation and the decades ahead; the natural lens itself, because early lens change points away from a phakic implant and towards lens surgery; the retina, particularly in high myopia; the ocular surface, because symptoms attributed to an implant are often surface disease; and the expectations, because a technically perfect implant in the wrong candidate is still the wrong operation. If the assessment you receive is materially shorter than that list, you have learned something useful about the provider.
The Part ICL Patients Need to Understand: Cataract Surgery May Still Be Part of Your Future
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. When that happens, the ICL can be removed as part of the transition to cataract surgery and an intraocular lens. The important point is not that cataract surgery is inevitable on a particular timetable. It is that an ICL provider should have thought about that future before implanting the lens today. At Blue Fin Vision®, the ICL-to-cataract transition is a written part of the pathway: the same clinical system that implanted and monitored your ICL manages its removal and your lens surgery when the time comes, alongside structured lifelong vault and endothelial monitoring at defined intervals under the Lifetime Monitoring Protocol™.
I also know the far end of that journey personally: I underwent cataract surgery myself in April 2024 and live with trifocal intraocular lenses in both eyes. When I tell a 30-year-old ICL patient what the distant future may hold, I am describing a road I have travelled.
And if it were my own child’s eyes, the test would be simple: I would want the surgeon to measure before recommending, to explain the sizing in words we could follow, to be capable of recommending a different operation or none, and to have written answers for year ten and year twenty. That is the standard this page is asking you to hold me to.
The Evidence I Put on the Table
- More than 57,000 ophthalmic procedures, including over 25,000 in the last four years, across ICL, laser and lens surgery.
- CertLRS, Moorfields training, a research MD and five consultant years at the Western Eye Hospital, Imperial College Healthcare NHS Trust.
- Six consecutive years of published, audited cataract surgery outcomes, the culture of measurement the laser and ICL pathways inherit.
- The Lifetime Monitoring Protocol™, written enhancement coverage for eligible self-pay laser and ICL patients within 24 months, and a written ICL-to-cataract position, all inside the Blue Fin Vision® Advantage.
- More than 550 verified Doctify reviews, Top Recommended status in the Spear’s 500 and inclusion in the Tatler Address Book, sitting alongside the clinical evidence, not replacing it.
The full surgeon-selection frameworks now live on their dedicated pages: Who Is the Best ICL Surgeon in the UK? and Who Is the Best Laser Eye Surgeon in the UK?
The system behind all of this is published: the Blue Fin Vision® Advantage, the Enhancement Policy, the ICL Surgery Checklist to test any provider against, including us, and transparent pricing on the ICL costs page. Take the checklist to any surgeon whose website makes a claim like this page’s title, including me, and compare the answers.
Blue Fin Vision® began with its flagship Harley Street clinic and now provides access to the same consultant-led standards at Weymouth Street, Chase Lodge Hospital in North West London, One Hatfield Hospital in Hertfordshire and Phoenix Hospital Chelmsford in Essex. The locations operate under one clinical governance model.
Book a consultation to discuss whether Laser Eye Surgery or ICL may be suitable for your eyes. Laser Eye Surgery consultations are complimentary. ICL consultations are paid, reflecting the depth and independence of a consultant-led clinical assessment.
References
- 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.
- 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.
- Randleman JB, Woodward M, Lynn MJ, Stulting RD. Risk assessment for ectasia after corneal refractive surgery. Ophthalmology. 2008;115(1):37-50. PMID: 17624434.
- Solomon KD, Fernández de Castro LE, Sandoval HP, Biber JM, Groat B, Neff KD, Ying MS, French JW, Donnenfeld ED, Lindstrom RL; Joint LASIK Study Task Force. LASIK world literature review: quality of life and patient satisfaction. Ophthalmology. 2009;116(4):691-701. PMID: 19344821.
- Sandoval HP, Donnenfeld ED, Kohnen T, Lindstrom RL, Potvin R, Tremblay DM, Solomon KD. Modern laser in situ keratomileusis outcomes. J Cataract Refract Surg. 2016;42(8):1224-1234. PMID: 27531300.
- Shortt AJ, Allan BD, Evans JR. Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database Syst Rev. 2013;(1):CD005135. PMID: 23440799.
- 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. Online ahead of print. doi:10.1016/j.oftale.2026.502616. PMID: 42476410.
- 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)
