ICL surgery can still be performed once presbyopia has started, but it will not remove the need for reading glasses, so other lens‑based options are often discussed.
When ICL may still be considered
Some patients prioritise distance over near independence.
- Clear natural lens with minimal cataract change
- Strong desire to retain accommodation and avoid lens replacement
- Acceptance of continued use of readers or bifocals for close work
- High prescriptions or corneal limits that favour an internal lens solution
- Healthy anterior chamber depth and endothelial cell counts
When other procedures are preferable
Presbyopia often shifts the balance.
- Significant near‑vision difficulties that you want to reduce
- Early lens ageing where refractive lens exchange may be more efficient
- Interest in multifocal or EDOF lens implants to broaden spectacle independence
- Reluctance to face both ICL removal and lens replacement later
- Decision that addressing the natural lens directly better matches long‑term goals
