ICL surgery can sometimes be performed in ocular hypertension, but the risk of pressure problems means suitability must be judged carefully.
Risks to consider
ICLs can influence fluid outflow.
- Vault that is too high can narrow the angle and raise pressure
- Pre‑existing tendency to high pressure reduces safety margin
- Greater need for regular pressure checks and possible medications
- Potential to unmask or accelerate glaucoma in susceptible eyes
- May affect eligibility for future angle‑based glaucoma procedures
Factors supporting cautious use
Some ocular hypertension patients may still be candidates.
- Well‑controlled pressures with healthy optic nerves and fields
- Wide angles and good drainage anatomy
- Strong refractive indication and lack of safer alternatives
- Agreement to close long‑term follow‑up and prompt treatment of any pressure rise
- Thorough risk-benefit discussion before proceeding
