ICL surgery can still be suitable over 40, but presbyopia and early lens changes need careful consideration.
When it may still be a good option
Some patients benefit despite age‑related changes.
- Clear natural lens with little or no cataract
- Strong desire to preserve accommodation and avoid lens replacement
- High prescriptions or corneal limitations making laser less suitable
- Understanding that reading glasses may still be needed as presbyopia progresses
- Healthy anterior segment and endothelium on detailed testing
When alternatives may be better
Lens‑based solutions often become more attractive.
- Established presbyopia where near vision is already problematic
- Early cataracts that are likely to progress
- Desire to address both distance and near vision in one lens procedure
- Willingness to accept permanent lens replacement instead of an add‑on ICL
- Shared decision that refractive lens exchange better meets long‑term goals
