---
title: At what level of residual prescription would enhancement be considered?
description: "Enhancement following ICL surgery is not a reflexive response to any measurable residual refractive error. Minor residual prescriptions - particularly within 0.50 dioptres of plano - may not produce meaningful functional impairment and do not require surgical correction. ¹ Enhancement…"
url: "https://bluefinvision.com/knowledge-base/topics/treatments-procedures/at-what-level-of-residual-prescription-would-enhancement-be-considered/"
updated: "2026-03-30"
category: "Treatments & Procedures"
---

# At what level of residual prescription would enhancement be considered?

Enhancement following ICL surgery is not a reflexive response to any measurable residual refractive error. Minor residual prescriptions - particularly within 0.50 dioptres of plano - may not produce meaningful functional impairment and do not require surgical correction. ¹ Enhancement is a clinical decision, not a metric one, and it requires both objective criteria and patient-reported functional concern to be present before a second procedure is appropriate.

At Blue Fin Vision®, the threshold for enhancement consideration is a residual refractive error of 1.00 dioptre or more, combined with the patient experiencing a genuine functional limitation attributable to that error. Below that threshold, continued monitoring and optical correction - where needed - is the preferred approach. Above it, the case for laser enhancement on clinical grounds is substantive. ²

This threshold is not arbitrary. It reflects the clinical risk-benefit calculation inherent in any elective surgical intervention: the corrective benefit of laser applied to a residual 0.50 D myope is modest; the benefit in a patient with a 1.50 D residual prescription is clinically meaningful. Applying the same threshold regardless of the patient's functional symptoms would be a departure from the individualised clinical decision-making that the Blue Fin Vision® consultation philosophy requires. ³

Patients should ask this question explicitly at their pre-operative consultation - not post-operatively when residual error has already been identified. Understanding the enhancement criteria in advance is part of the informed consent process.

**References**

1. Ganesh S, Brar S. Clinical outcomes of phakic intraocular lens implantation for the correction of high myopia with three years of follow-up. Clin Ophthalmol. 2013;7:2011–2021. PMID: 24204123.
2. Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol. 2016;10:1059–1077. PMID: 27390517.
3. Kohnen T, Maxwell WA, Holland S, Tetz M. Intraocular collamer lens for high myopia: results from the ICL in Treatment of Myopia (ITM) study. Ophthalmology. 2008;115(8):1392–1400. PMID: 18359068.

**Related Topics**

- [ICL Surgery Checklist](https://bluefinvision.com/blog/icl-surgery-checklist/)
- [Are You on the GMC Specialist Register for Ophthalmology?](https://bluefinvision.com/knowledge-base/topics/eye-health/are-you-on-the-gmc-specialist-register-for-ophthalmology/)
- [Does Your Surgeon Hold the CertLRS Qualification?](https://bluefinvision.com/knowledge-base/topics/eye-health/does-your-surgeon-hold-the-certlrs-qualification/)
- [How Many ICL Procedures Has Your Surgeon Performed?](https://bluefinvision.com/knowledge-base/topics/diagnostics-testing/how-many-icl-procedures-has-your-surgeon-performed-in-total-and-how-many-do-they-do-each-year/)
- [Can You Show Me Your Refractive Outcome Data?](https://bluefinvision.com/knowledge-base/topics/diagnostics-testing/can-you-show-me-your-refractive-outcome-data/)
- [Is Surgery Performed in a Proper Hospital Theatre with Laminar Airflow?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/is-surgery-performed-in-a-proper-hospital-theatre-with-laminar-airflow/)
- [What Is My Pre-Operative Endothelial Cell Count?](https://bluefinvision.com/knowledge-base/topics/diagnostics-testing/what-is-my-pre-operative-endothelial-cell-count/)
- [How Often Will ECC and Vault Be Monitored, and Is This Included?](https://bluefinvision.com/knowledge-base/topics/recovery-aftercare/how-often-will-endothelial-cell-count-and-vault-be-monitored-and-is-this-included-in-the-price/)
- [What Vault Are You Targeting?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/what-vault-are-you-targeting-and-how-will-you-manage-it-if-it-is-too-high-or-too-low/)
- [Does the Clinic Have Access to Laser Eye Surgery for Enhancement?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/does-the-clinic-have-access-to-laser-eye-surgery-for-enhancement-if-needed/)
- [Which ICL System and Calculator Do You Use?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/which-icl-system-and-calculator-do-you-use/)
- [What Happens If I Develop a Cataract Within Two Years?](https://bluefinvision.com/knowledge-base/topics/conditions-diseases/what-happens-if-i-develop-a-cataract-within-two-years-of-surgery/)
- [What Is the Arrangement If Cataract Develops Between Two and Ten Years?](https://bluefinvision.com/knowledge-base/topics/conditions-diseases/what-is-the-arrangement-if-cataract-develops-between-two-and-ten-years/)
- [Have You Performed Cataract Surgery in an Eye with an Existing ICL?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/have-you-performed-cataract-surgery-in-an-eye-with-an-existing-icl/)
- [How Do You Manage Biometry Calculations in Post-ICL Eyes?](https://bluefinvision.com/knowledge-base/topics/diagnostics-testing/how-do-you-manage-biometry-calculations-in-post-icl-eyes/)
- [What Happens If My Myopia Continues to Progress?](https://bluefinvision.com/knowledge-base/topics/conditions-diseases/what-happens-if-my-myopia-continues-to-progress-after-surgery/)
- [At What Level Would Enhancement Be Considered?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/at-what-level-of-residual-prescription-would-enhancement-be-considered/)
- [When After Surgery Would Enhancement Be Performed?](https://bluefinvision.com/knowledge-base/topics/recovery-aftercare/when-after-surgery-would-enhancement-typically-be-performed/)
- [Who Performs the Enhancement – the Same Consultant?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/who-performs-the-enhancement-the-same-consultant/)
- [Is Laser Enhancement Included in the Price?](https://bluefinvision.com/knowledge-base/topics/treatments-procedures/is-laser-enhancement-included-in-the-price-and-for-how-long/)
- [Is Sedation Available, and What Does It Cost?](https://bluefinvision.com/knowledge-base/topics/suitability/is-sedation-available-and-what-does-it-cost/)
- [Is Oral Diazepam Available for Anxious Patients?](https://bluefinvision.com/knowledge-base/topics/suitability/is-oral-diazepam-available-for-anxious-patients-and-is-there-a-charge/)
- [What Is the Minimum Stay Required Near the Clinic?](https://bluefinvision.com/knowledge-base/topics/recovery-aftercare/what-is-the-minimum-stay-required-near-the-clinic-after-surgery/)
- [Will You Identify a Named Local Ophthalmologist Before Surgery?](https://bluefinvision.com/knowledge-base/topics/recovery-aftercare/will-you-identify-a-named-local-ophthalmologist-before-surgery-for-ongoing-follow-up/)
- [How Will Annual Vault and ECC Monitoring Be Arranged If I Live Far Away?](https://bluefinvision.com/knowledge-base/topics/recovery-aftercare/how-will-annual-vault-and-endothelial-cell-monitoring-be-arranged-if-i-live-far-away/)