For younger patients with very high myopia, both ICL surgery and refractive lens replacement can achieve the required optical correction. The decision between them at Blue Fin Vision® rests on one critical consideration: whether the patient’s natural accommodation should be preserved.
ICL surgery places a thin lens behind the iris while leaving the natural crystalline lens intact. The eye retains its full ability to accommodate, allowing patients to focus naturally across a range of distances without an artificial lens performing that function.¹
Lens replacement surgery removes the natural lens entirely. While modern multifocal and EDOF lenses provide functional vision across multiple distances, they do not replicate natural accommodation. For a 28-year-old patient, the loss of accommodation for the next two decades has real practical consequences that patients often underestimate before surgery.
At Blue Fin Vision®, for patients under 40 with a healthy natural lens, ICL is the preferred approach for very high myopia provided anterior chamber depth is adequate. Lens replacement in this age group is reserved for cases where the prescription cannot be safely corrected with ICL, or where the natural lens is already showing early dysfunction.²
Modern ICL designs have demonstrated excellent long-term visual outcomes and safety profiles in multiple studies for patients with moderate-to-very-high myopia.³ The reversibility of ICL, unlike laser surgery or lens replacement, is an additional advantage for younger patients whose prescription may continue to evolve.
References
- Packer M. The Implantable Collamer Lens with a central port: review of the literature. Clin Ophthalmol. 2018;12:2427–2438.
- Alió JL, Grzybowski A, El Aswad A, Romaniuk D. Refractive lens exchange. Surv Ophthalmol. 2014;59(6):579–598.
- Shimizu K, Kamiya K, Igarashi A, Shiratani T. Long-term comparison of posterior chamber phakic intraocular lens with and without a central hole implantation for moderate to high myopia and myopic astigmatism. Medicine (Baltimore). 2016;95(14):e3270.
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