ICL vs. LASIK: Comparing Options to Correct Refractive Errors

LASIK and ICL represent two different ways to improve vision. Since ICL is a more invasive surgery, most surgeons recommend LASIK over ICL if the person is a good candidate for LASIK. 

LASIK vs. ICL

LASIK (laser-assisted in situ keratomileusis) and ICL (implantable collamer lens) surgeries both correct refractive errors, such as myopia, hyperopia, and astigmatism. Both procedures are safe and effective avenues to improve vision, and both boast high patient satisfaction rates. 

However, the two treatments are very different in their approach as well as the technology and methods utilized to deliver a successful outcome.

More About LASIK

LASIK (commonly referred to as laser eye surgery) is a form of vision correction that utilizes laser technology. It has been in practice since the 1990s. 

Through laser technology, LASIK can reshape the curvature of the cornea, resulting in the correction of refractive errors. 

LASIK involves tissue removal that helps the eyes achieve normal vision again. The cornea has the ability to bend or refract light onto the retina that is located at the back of the eye. When nearsightedness, farsightedness, or astigmatism is present, the light is not bent or refracted normally, resulting in compromised vision.

While many individuals wear glasses or contact lenses to correct their vision, LASIK provides a solution that helps many individuals achieve normal vision without corrective lenses.

More About ICL

With ICL, an artificial lens is implanted in the eye, carefully positioned between the iris and the eye’s natural lens. People sometimes compare the lens to a permanent contact lens.

The procedure usually takes less than 30 minutes.

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Who Is the Ideal Candidate for LASIK & ICL? 

In most cases, doctors will recommend LASIK to correct refractive errors since it is a more straightforward procedure. But if someone is not a candidate for LASIK, ICL might be recommended.

Candidacy for LASIK

The ideal candidate for LASIK meets these criteria:

• At least 21 years old
• Has good overall eye health
• Has good corneal health with sufficient thickness
• Has had a stable prescription for at least one year prior to the procedure

Candidacy for ICL

The ideal candidate for ICL surgery meets these criteria:

• At least 21 years old 
• Has a stable prescription that hasn’t changed significantly in the past year
• Has good overall eye health
• Has healthy corneas
• Has a prescription suited for the ICL procedure 

Factors to Consider

ICL is sometimes recommended for people who are not good candidates for LASIK due to thin corneas or severe myopia. If someone has a family history of corneal disease or irregular corneas, ICL may also be preferred. If you have chronically dry eyes, ICL can be a better choice than LASIK.

While 18 years old is sometimes cited as the minimum age requirement for both procedures, most experts recommend 21 years old as the minimum. It may be even better to wait until around 25 years old when vision is more stable. 

Differences & Similarities Between LASIK & ICL 

LASIK and ICL are objectively very different surgeries. While LASIK involves the permanent removal of corneal tissue, ICL does not remove any tissue but instead places a collamer lens in the eye.

Both LASIK and ICL procedures are widely considered pain-free with minimal discomfort during the procedure. Both procedures have a good safety record and little to no downtime after the procedure. 

In ideal circumstances, both procedures help a wide range of patients achieve significantly improved vision, often helping the patient to achieve 20/20 vision.

Since ICL is a much more invasive surgery, it has a higher risk of infection compared to LASIK. There is also a higher chance of eye damage during ICL compared to LASIK. Though these instances are still very rare, the complication rate is still higher than it is with LASIK.

Pros & Cons of Each Procedure

Pros of both LASIK and ICL include the following:

• Very short procedure, as both can be completed in less than an hour 
• Short recovery time
• High success rates

As with any surgical procedure, there are certain risks involved with LASIK and ICL. The risk of each of these is low, as most people have success without complications with both surgeries.

Cons of LASIK include the following: 

• Risk of undercorrection or overcorrection, which may necessitate a follow-up procedure or the need to continue wearing corrective lenses
• Risk of infection
• Not an option for people with thin corneas, very high myopia, or other conditions
• Risk of side effects, like dry eyes, night vision issues, and glare or halos around lights

Cons of ICL include risks of the following: 

• Increased eye pressure if the lens is implanted incorrectly 
• Retinal detachment
• Cloudy cornea
• Eye infection

Which Procedure Is the Right Choice for Me? 

In most cases, an eye surgeon will recommend LASIK over ICL if the patient is a good candidate for LASIK. If you have any condition that makes you a poor candidate for LASIK, such as thin corneas or dry eye, your surgeon may recommend ICL.

ICL is a much more expensive procedure than LASIK, and it can be more challenging to find surgeons that specialize in ICL. 

The decision of the best surgery to correct your vision will be very individual. Ask your eye doctor to assess your eyes and vision goals, and they can guide you on the best choice for you.

References

1. Implantable Collamer Lens. (December 2022). American Academy of Ophthalmology.

2. A Prospective Comparative Study Between Implantable Phakic Intraocular Contact Lens and Implantable Collamer Lens in Treatment of Myopia in Adults. (March 2022). Journal of Ophthalmology.

3. Pure ICL Implantation: A Novel Ophthalmic Viscosurgical Device-Free Method. (October 2021). Journal of Ophthalmology.

4. Comparison of Clinical Outcomes of LASIK, Trans-PRK, and SMILE for Correction of Myopia. (February 2022). Journal of the Chinese Medical Association.

5. Optical and Visual Quality Comparison of Implantable Collamer Lens and Femtosecond Laser Assisted Laser in Situ Keratomileusis for High Myopia Correction. (May 2021). International Journal of Ophthalmology. 

6. LASIK Eye Surgery. U.S. National Library of Medicine.

7. LASIK Candidate. Harvard Medical School, Department of Ophthalmology.

8. Implantable Collamer Lens for Residual Refractive Error After Corneal Refractive Surgery. (October 2016). International Journal of Ophthalmology.

9. Two-Year Visual Outcomes of Evolution Implantable Collamer Lens and Small Incision Lenticule Extraction for the Correction of Low Myopia. (April 2022). Frontiers in Medicine.