Cataract occurring between two and ten years after ICL implantation occupies a clinically and financially distinct category. It is no longer an early post-operative complication attributable solely to the surgical episode. It is also not the natural age-related lens change that would be expected in a patient in their fifties or sixties – ICL patients in this timeline are typically in their mid-thirties to mid-forties, and cataract in this age group is premature. ¹ ²
The most clinically appropriate management in this window is conversion to lens replacement surgery. The ICL is removed, the natural crystalline lens is extracted by phacoemulsification, and a premium intraocular lens is implanted. For patients who had originally hoped to preserve their natural lens for decades, this represents a material change in their refractive pathway – and the financial implications are significant.
At Blue Fin Vision®, the Blue Fin Vision® Advantage covers 50% of the lens replacement cost in the two-to-ten-year window following ICL surgery. This is not a standard offering in UK private refractive practice. The reasoning behind it is consistent with Blue Fin Vision®’s clinical philosophy: a patient who develops early cataract after ICL surgery has almost certainly experienced a degree of vault-related lens stress, and the practice that performed the original procedure carries a degree of shared responsibility for the downstream management. ³
This arrangement is discussed explicitly at the pre-operative consultation and documented in the patient’s care agreement.
References
- Sanders DR. Anterior subcapsular opacification with the implantable contact lens. J Refract Surg. 2003;19(4):415–422. PMID: 12916486.
- Zaldívar R, Davidorf JM, Oscherow S. Posterior chamber phakic intraocular lens for myopia of –8 to –19 dioptres. J Refract Surg. 1998;14(3):294–305. PMID: 9652203.
- 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.
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?
