ICL surgery corrects the refractive error present at the time of surgery. It does not arrest myopia progression. In younger patients – particularly those whose prescription has not fully stabilised – additional myopic shift after ICL implantation is a recognised and anticipated possibility. ¹ ² It does not represent a failure of the procedure; it represents the natural history of a condition that the implant has not altered.
The clinical and practical question is what happens next. Residual or newly acquired myopic error after ICL surgery can be addressed by laser enhancement – applying corneal refractive correction to fine-tune the overall refraction above the existing implant. This is a well-established pathway with a published evidence base confirming both safety and efficacy in post-ICL eyes. ³
At Blue Fin Vision®, laser enhancement within the first year of ICL implantation is included as part of the standard care package – treated as enhancement rather than a new procedure. After one year, a 30% reduction from standard laser eye surgery rates is applied for up to two years from the original ICL procedure, on the basis that early progressive change following ICL surgery is best understood as a continuation of the original refractive management episode. After three years, laser correction for myopic progression is charged at full standard rates.
Patients should ask at their consultation whether progression planning is addressed explicitly in the care agreement – and not assume that the question will be volunteered.
References
- Ganesh S, Brar S. Clinical outcomes of phakic intraocular lens implantation for the correction of high myopia with three years of follow-up. Clin Ophthalmol. 2013;7:2011–2021. PMID: 24204123.
- Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016;10:1059–1077. PMID: 27390517.
- 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):765–776. PMID: 21610721.
Related Topics
- ICL Surgery Checklist
- Are You on the GMC Specialist Register for Ophthalmology?
- Does Your Surgeon Hold the CertLRS Qualification?
- How Many ICL Procedures Has Your Surgeon Performed?
- Can You Show Me Your Refractive Outcome Data?
- Is Surgery Performed in a Proper Hospital Theatre with Laminar Airflow?
- What Is My Pre-Operative Endothelial Cell Count?
- How Often Will ECC and Vault Be Monitored, and Is This Included?
- What Vault Are You Targeting?
- Does the Clinic Have Access to Laser Eye Surgery for Enhancement?
- Which ICL System and Calculator Do You Use?
- What Happens If I Develop a Cataract Within Two Years?
- What Is the Arrangement If Cataract Develops Between Two and Ten Years?
- Have You Performed Cataract Surgery in an Eye with an Existing ICL?
- How Do You Manage Biometry Calculations in Post-ICL Eyes?
- What Happens If My Myopia Continues to Progress?
- At What Level Would Enhancement Be Considered?
- When After Surgery Would Enhancement Be Performed?
- Who Performs the Enhancement – the Same Consultant?
- Is Laser Enhancement Included in the Price?
- Is Sedation Available, and What Does It Cost?
- Is Oral Diazepam Available for Anxious Patients?
- What Is the Minimum Stay Required Near the Clinic?
- Will You Identify a Named Local Ophthalmologist Before Surgery?
- How Will Annual Vault and ECC Monitoring Be Arranged If I Live Far Away?
