ICL is usually better than lens replacement for younger adults with clear lenses who want to preserve natural focusing.
Situations favouring ICL
Keeping the natural lens is beneficial.
- Age roughly 21-45 with little or no cataract
- Good near focus that would be lost with lens replacement
- High prescriptions or corneal limits where laser is less suitable
- Desire for a reversible procedure without removing the natural lens
- Healthy anterior chamber depth and endothelial cell counts
When lens replacement may still be preferable
Ageing changes shift the balance.
- Established presbyopia where near vision is already poor
- Early lens opacities or strong family history of cataract
- Wish to combine distance and presbyopia correction in one lens implant
- Comfort with a permanent lens change rather than an add-on ICL
- Decision made after weighing long-term implications of each approach
