ICL surgery is generally not a priority in macular degeneration, because retinal disease rather than refractive error usually limits vision.
Reasons for caution
Improving focus does not repair the macula.
- Central distortion or scotoma will persist despite perfect optical correction
- Surgical risk may outweigh modest gains in clarity
- Macular disease can progress, reducing long‑term benefit of ICL
- Ongoing injections or monitoring are needed regardless of refractive status
- Low‑vision aids and medical treatments often offer more benefit
Possible exceptions
Very carefully selected patients may be considered.
- Early, stable macular changes with good potential visual acuity
- Strong functional need to reduce very high spectacles for mobility or work
- Full agreement that expectations are limited and disease may progress
- Close collaboration with a medical retina specialist
- Alternative approaches usually remain first‑line
