ICL vs. LASIK: Differences & How to Choose

Both ICL and LASIK are designed to permanently correct refractive errors that affect how a person focuses and sees. LASIK reshapes the cornea with a laser, while ICL involves implanting a contact lens into the eye.

LASIK is widely viewed as a safer surgery option since it has a lower risk profile and leads to fewer side effects, but in some cases, ICL is the better choice. Both surgeries can effectively correct vision, but they are very different procedures.

ICL Vision Correction vs. LASIK

ICL is an acronym that stands for interocular contact lens or implanted collamer lens. It is an alternative to LASIK for people who have myopia.

LASIK, which stands for laser-assisted in situ keratomileusis, is a refractive surgery procedure that is used to reshape the cornea to improve the vision of people who have nearsightedness, farsightedness, or astigmatism.

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ICL & LASIK: How Each Works

ICL is a process where the eye doctor implants a tiny collamer lens into the eye. It is similar to a contact lens, but it stays in the eye. 

During LASIK, the surgeon makes a flap with a microkeratome (blade) or laser keratome (femtosecond laser), so they can reshape the cornea. The cornea is reshaped using an excimer laser.

Both LASIK and ICL offer a permanent solution to vision correction, but ICL is reversible. The results of LASIK cannot be reversed, though people can receive enhancement (additional) LASIK surgeries in some cases if they didn’t achieve the desired results with the initial surgery.

FDA Approval

The FDA has approved both ICL and LASIK.

ICL

The FDA initially approved ICL treatments for patients with nearsightedness (myopia) that is defined as moderate to severe: -3.00D to -20.00D. But the FDA recently approved ICL treatments for patients with nearsightedness and astigmatism. This announcement was made in March 2022.

A Staar Surgical news release stated that its biocompatible EVO lens is made for use in phakic eye treatment procedures for people who are 21 to 45 years old. 

This advancement will allow surgeons to correct or reduce myopia in patients who have -3.0 D to -20.0 D spherical equivalents and correct or reduce myopic astigmatism in those who have 3.0 D to 20.0 D spherical equivalents and a cylinder (CYL) of 1.0 D to 4.0 D. 

CYL refers to the degree of astigmatism. The patient also must have had a stable refractive history within 0.5 D for a year before implantation.

This ICL transplant is inserted inside the posterior chamber of the eye, behind the iris and in front of the lens.

LASIK

LASIK is FDA-approved for the treatment of nearsightedness or farsightedness, with or without astigmatism. However, treatment for nearsightedness is limited to -14.00 D, narrowing down the scope of treatment in this respect.

Differences Between ICL & LASIK

Though ICL and LASIK can both correct vision, they are fundamentally different procedures. Here are some of their differences:

How the Surgery Works

LASIK involves reshaping the cornea with a laser to correct nearsightedness, farsightedness, or astigmatism. ICL involves placing a contact lens in the eye, which is like a permanent contact lens.

ICL is a much more invasive procedure than LASIK.

Eligibility

People with thin corneas or dry eyes may not be good candidates for LASIK. In some cases, ICL will work well for these individuals. In a pre-surgical consultation, your eyes will be tested and measured to determine your eligibility for either surgery.

LASIK can correct more refractive errors than ICL. Now, ICL can treat both myopia and astigmatism, but LASIK can correct nearsightedness, farsightedness, and astigmatism.

Success Rates

Both LASIK and ICL can successfully correct vision, and both surgeries boast high rates of patient satisfaction. Since the recovery period from LASIK is faster, patients often prefer this surgery if both types of procedures are available to them.

Permanency 

ICL is considered permanent, although you can have the procedure reversed and the lens removed. Many people leave the lenses in their eyes indefinitely.

LASIK is not reversible since the cornea is reshaped. If vision is undercorrected, another LASIK procedure can be performed to further correct vision.

Risks

ICL is a more invasive surgery, so it has a higher risk of infection following the surgery. LASIK has a higher potential for night vision issues after surgery, such as halos or glares around lights at night.

Recovery

LASIK offers a faster recovery period than ICL. Most patients have clear vision the day following LASIK, though some blurriness may be present for a couple days. With ICL, vision takes about a week to 10 days to clear.

Cost

LASIK is a more cost-effective procedure than ICL. LASIK generally costs a couple thousand dollars less per eye than ICL.

How to Choose the Right Surgery for You

If you are eligible for LASIK, your eye surgeon will likely recommend this surgery as the best choice for you due to its high success rates, fast recovery time, low risk profile, and cost-effectiveness. 

If you aren’t a candidate for LASIK, potentially due to dry eyes or thin corneas, ICL may be a good option for you. 

The right choice for you will depend on your eye health, refractive error, and eye conditions. Talk to your eye surgeon about what will work best for your situation.

References

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

2. EVO/EVO+ VISIAN Implantable Collamer Lens – P030016/S035. U.S. Food & Drug Administration.

3. FDA Approves STAAR Surgical’s EVO Visian ICL for Myopia. (March 2022). Optometry Times.

4. What Do Astigmatism Measurements Mean? (April 2021). American Academy of Ophthalmology.

5. LASIK. U.S. Food & Drug Administration.

6. Surgery for Retinal Detachment. (December 2020). National Eye Institute.

7. Five-Year Outcomes of EVO Implantable Collamer Lens Implantation for the Correction of High Myopia and Super High Myopia. (2021). Eye and Vision.

8. What Are the Risks and How Can I Find the Right Doctor for Me? U.S. Food & Drug Administration.

9. LASIK Surgery Checklist. U.S. Food & Drug Administration.

10. LASIK Beats Contact Lens in Key Areas. (May 2018). Review of Optometry.

11. Effects of Tilt and Decentration of Visian Implantable Collamer Lens (ICL V4c) on Visual Quality: An Observational Study. (July 2022). BMC Ophthalmology.

12. Evaluation of Dry Eye After Implantable Collamer Lens Surgery. (June 2021). Ophthalmic Research.

13. 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.