ICL vs LASIK

Key Takeaways

• Visian implantable collamer lens (ICL) and laser-assisted in situ keratomileusis (LASIK) are FDA-approved vision correction procedures. They are both safe and effective.
• ICL only corrects myopia, while LASIK corrects myopia, hyperopia, and astigmatism.
• During ICL, permanent lenses are inserted into the eyes to enhance visual acuity.
• During LASIK, a femtosecond laser creates a thin flap and an excimer laser removes tissue around the cornea to reshape it. 
• Although LASIK is less expensive and easier to perform, people with thin corneas or very high prescriptions are not eligible.
• The qualifying age for LASIK is 18. For ICL, it’s between 21 and 45.

How Do ICL and LASIK Compare? 

In recent years, laser surgeries such as LASIK have revolutionized the world of vision correction.¹

However, laser corrective therapy isn’t the only remedy for refractive errors. New alternatives like the Visian implantable collamer lens (ICL) also improve vision.²

When comparing LASIK and Visian ICL, the primary difference is the visual problems treated.

The FDA approved LASIK to treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. ICL is only approved to correct nearsightedness.

How the Surgeries Differ

ICL involves inserting permanent lenses into the eye for better vision, while LASIK fixes refractive errors using an excimer laser.³

Although most refractive errors can be treated with LASIK, those at risk for chronic dry eyes prefer Visian ICL.

LASIK is more cost-effective, treats more conditions, and has a faster recovery timeline than ICL. While most LASIK patients attain good vision a day after the surgery, ICL patients take at least 7 days to achieve clear vision. 

Considering the invasive nature of ICL, it has a higher risk of severe eye infection than LASIK.

ICL offers a permanent solution and has fewer side effects than LASIK.

What is ICL?

ICL is an abbreviation for implantable collamer lens (ICL). It’s a treatment approved by the FDA for myopia (Visian ICL V4 is another brand). 

A newer version known as Visian Toric ICL is now available to treat astigmatism that occurs alongside myopia.⁸

Commonly referred to as Visian ICL, this surgical eye procedure is an excellent alternative to laser-based procedures such as LASIK.

During Visian ICL, the eye surgeon makes a small incision in the cornea. Then they insert an artificial lens through the incision using a special injector.

The implantable lens is placed in front of the eye’s natural lens, not to replace it but to complement it.

This procedure takes about 15 minutes for each eye.

Visian ICL is ideal for people with thin corneas who don’t qualify for LASIK surgery. It’s also a preference for those at risk of dry eyes.

Who Qualifies for ICL?

You qualify for Visian ICL if you:⁴

• Are between 21 and 45 years old
• Aren’t a good LASIK candidate 
• Have moderate to severe myopia
• Have minor to no astigmatism
• Have good general eye health with no history of trauma
• Do not take medications such as steroids that can interfere with healing
• Have at least 6 months to a year of unchanged vision correction prescriptions
• Aren’t pregnant or breastfeeding
• Aren’t allergic to local anesthetic eye drops

Pros of ICL

• Ideal for patients with higher amounts of myopia (-3.0 diopters to -20.00 diopters), unlike LASIK (up to -12.00 diopters only)
• Results in clearer vision
• Works for patients who are ineligible for LASIK
• Minimal to no maintenance
• Completely reversible 
• A long-term solution
• No risk of dry eyes
• No need for glasses or contact lenses after ICL.

Cons of ICL

• Not covered by insurance because it’s an elective surgery
• Has an age limit of 21 to 45 years
• More expensive than laser treatments

Costs

Visian ICL costs about $4,000 to $5,000 or more per eye. Because refractive surgery is considered elective, insurance will not cover it.

The cost of ICL may also vary from one provider to the other.

Regardless of the cost, ICL is worth it if you’re aiming for a long-term solution for myopia.

What is LASIK?

Laser in-situ keratomileusis, popularly known as LASIK eye surgery, is a corrective treatment for vision problems.⁵

If the cornea is irregularly shaped, light might not focus well, leading to blurry vision. This is known as refractive error.⁶

LASIK surgery changes the shape of the cornea to correct the refractive error. The cornea is the clear part of your eye that focuses light on the retina, enabling clear vision.

The four types of refractive errors LASIK treats include:

1. Myopia (nearsightedness)
2. Hyperopia (farsightedness) 
3. Astigmatism (uneven flattening of the cornea)
4. Presbyopia (age-related farsightedness)

During LASIK, the eye surgeon uses a device called a femtosecond laser to cut out a flap in the cornea and fold it backward. 

They then safely remove some tissue from strategic areas in the cornea before placing the flap into position. This reshapes the cornea and improves vision. 

According to the Food and Drug Administration (FDA), LASIK is a safe alternative to prescription glasses and contact lenses.

Who Qualifies for LASIK?

You’re a good candidate for LASIK eye surgery if you:

• Are 18 years or older
• Maintain good general health
• Have no eye diseases
• Have good general eye health with no history of trauma
• Aren’t pregnant or nursing
• Have a thick cornea

LASIK is not for everyone, and there are other factors that might make you ineligible for the procedure. Consult your doctor before making any decision about the surgery.

Pros of LASIK

• A quick and safe procedure
• Fast outcomes with a clear vision after 24 hours
• No need for eyeglasses or contact lenses
• Creates 20/20 vision

Cons of LASIK

• Poses a risk of under-correction or overcorrection⁷
• Might require LASIK enhancement (repeat surgery) if the desired outcomes are not achieved 
• Might develop corneal flap complications such as infections
• Not everyone is eligible (you must be 18 years or older)
• Increases risk of dry eyes
• Might cause nighttime glares and halos
• Requires post-op care to prevent complications

Costs

The price of LASIK is usually advertised “per eye.” There are a number of factors that might affect price, which makes it difficult to predict expenses before your qualifying test. 

Factors influencing cost include:

• The kind of LASIK done (microkeratome blade or full laser system) 
• The brand of technology used and the complexity of the surgery 
• Your individual expectations
• Guarantees offered for follow-up enhancements
• Available pre- and post-surgery services
• The expertise, competence, and reputation of your surgeon
• Location of your doctor

Is LASIK or ICL Right for You?

When choosing between ICL and LASIK, your doctor will likely recommend the surgery that’s best for your condition. 

If you have myopia (shortsightedness) and you qualify for both vision correction options, your doctor will likely choose LASIK over ICL. 

This is because LASIK is less invasive, simple to perform, and less expensive compared to ICL. 

However, LASIK is not ideal if you have thin or flat corneas. In this case, ICL would be a better option.

Both LASIK and ICL are effective in treating eye problems. Always consult a qualified optometrist before undergoing any of the procedures.

Tips to Prepare for Treatment

• If you use contact lenses, remove them and allow your eyes to rest for several days before surgery, or as advised by your doctor.
• Avoid wearing fragrance and makeup on the surgery day.
• Keep taking your prescription medication unless your doctor says otherwise.
• Eat a light meal at least 5 hours before surgery. Talk to your doctor if you have diabetes or other autoimmune disorders, which might affect your eating schedule.
• Arrange for transportation post-surgery, as you may not be able to drive after the procedure.
• Discontinue medications that could affect the healing process, such as anticoagulants like warfarin.
• Inform your doctor if you experience any issues, such as irritation or sudden visual changes, before the surgery.