r/ICLsurgery

A nice benefit of having ICL surgery over laser eye surgeries such as lasik is the significantly lower issue of dry eye. Because ICL doesn’t involve any corneal flap or removal of any corneal tissue, the corneal nerves responsible for triggering tear production remain largely intact. But this does not mean that ICL is “dry eye free”. There will still be some post-operative dry eye with ICL.

Dilating drops and antiseptic used prior to the surgery irritate the surface of the eye. On top of this, during surgery, the eye is held open while the surgeon places the ICL lens. This causes the eye to dry out a little more. So immediately after ICL, the cornea is more irritated and dry just from going through a procedure.

Additionally, ICL involves a small incision in the cornea. This incision does disrupt a small localized amount of nerves within the cornea. These nerves within the cornea are important to signal tear production when the eye is drying out. So until these nerves regenerate, the cornea is a little less sensitive and less capable to responding to dry eye.

But the biggest contributing factor to dry eye after ICL is the post-op eye drops. After ICL, many of the prescribed antibiotic and steroid eye drops contain preservatives to prevent the eye drop from going bad. Preservatives are known to irritate the cornea. And so the use of these drops after the surgery will cause some additional corneal irritation and dry eye. (But not enough to outweigh the benefit of the medication in the drop. Still continue to follow your doctor’s instructions).

Fortunately this post-operative dry eye after ICL surgery is usually very transient and once the post-operative eye drops are finished, the cornea heals up and the dry eye improves. In the meantime, however, using preservative-free artificial tears can help with the recovery to minimize this post-operative dry eye as much as possible and allow for the quickest healing.

I had EVO ICL done about a day and a half ago. Reading some posts here almost made me not go through with it, but I’m super glad I did. Here’s how it was for me:

Large clinic in Seattle Bellevue.

I was stuck in highway traffic when I was due to start my dilating eye drops, so I had to apply them while driving. I just made it to the hotel parking lot when my vision started getting blurry! Luckily I brought sunglasses.

I was examined by a nurse, given medication and Valium to relax me, numbing eye drops, the surgeon measured my eyes for the correct ICL lens size and confirmed I was a good fit, then walked into the operating room.
They had me lay down on the table, and the assistant put tons of drops in my eyes. Like tons. After that, they taped back my eyelids so I couldn’t blink, covered my eye (right) with a large sheet of gauze (I think) with a whole in the middle to work through, then fit over what felt like a huge contact lens with a hole in the middle.
This is where the fun (pain) begins. The surgeon needs to use a crazy bright light to see into your eye, and you need to stare directly into said light the whole time. I felt a little pressure as he made the incision and pushed the lens into my eye, but it was a very distant discomfort and was nothing compared to the pain of staring right into that bright ass light. After he fit the lens (talking me through everything he was doing as he did it) he had to wash out the gel that is used to place the lens for about 4 minutes. Worst part by far. Some pressure and lots of swimming in my vision, but they counted down so I know it was gonna end. After that he was done with my first eye, I got sweet relief as I closed it.
Same exact sequence for my left eye, then more eye drops for both eyes and some wipes to wipe away the excess drops and remove the adhesive from my face. All in all from arriving to walking out it took about 1:15, if that the surgery was probably 20 minutes.
Walking out my vision was blurry but I could see OK, I ubered to my hotel and fell asleep. I woke up about 3 hours later feeling much better. Vision was improving as the dilation wore off, and even right after the surgery I had no appreciable pain. After surgery I set a rolling alarm to apply eye drops to moisten my eyes. I got some sushi, watched YouTube and went to bed.
I woke up with 20/20 vision. It was crazy. There was a little blurriness when I woke, but it was obvious I could drive, so I drove to my 24 hour follow up. No problems, vision was 20/20 and fit was looking good.

The “I ain’t reading all that” version of the above:
Surgery is fast but staring into a blinding light for ~9 minutes per eye is painful. No pain after, rapid recovery, 20/20 vision 24 hours later.

I am so glad I had this done. Halos are present, but they are faint and at the edges of my vision so they aren’t a big bother. I’ll update this at 1 week, 1 month 6 months and onward if I can remember to.

3 days post op: Eyes feel very normal, just can't rub them aggressively like you would normally. I'm wearing sunglasses outside and applying artificial tears regularly. The halos are definitely present when there are lights towards the side of my FOV that are brighter than the background, but they aren't irritating so far. I haven't tried driving at night yet, but I'll update this post when I do.

Some info about me for posterity:
25 years old
Male
Large pupils
-3.25 and -4 glasses RX

31F

R

-8.75 -1.25 Axis 003

L

-9.00 -0.75 Axis 178

I'm considering ICL Surgery in the next few years and trying to absorb as much information as I possibly can.

How do I find the most qualified surgeons close to me?

What are the important questions that I should be asking when I go for my consultation?

I live in Lansdale, Pennsylvania so if anyone local can recommend a great surgeon that would be awesome.

Is there someone who wear extended wear contact lenses for years and had the surgery with no problem . the count of the endothelial cells was good

Hello ,

I have a question if someone can weigh in. I am 52 with a -9.5 Rx

I use reading glasses occasionally at work , but can function without them

With my Rx glasses off, I can read well up close ( as in inches ) but cannot read close with my regular / non reading glasses in

After ICL surgery I understand that I will still have age related issues and need reading glasses

What I do not understand is my up close vision ( again within inches ) THAT vision is worse with my regular -non reading glasses

Hope my non eye professional phrasing makes sense

Regards

Hello! I’m 11 days post op, and generally have had great results and fast recovery. However, I do have some issues (see below) and hope others can chime in on whether these go away since I’m still less than 2 weeks post op.

**Background**

My script going in was around -5 in both eyes with a very slight astig (.025) in my left eye. This was too small to correct with EVO which starts at 1 or higher. My pupil size is 3mm normal and 5mm dark, so I got standard size ICL which cover up to 6mm (no need for plus).

**Procedure**

The actual procedure was absolutely painless and fast. They dilated my eyes, we went to the operating room where they administered several numbing drops. I looked up at white lights while the doctor explained a few things then he said “ok the right eye is done”. I didn’t even feel pressure. They reset the operating room and did the same of the left. No issues. When I sat up they asked if I could see the clock. I could but not clearly. It looked like I was underwater / looking through smoke. Very hazy, but that was expected. Note that I did have a very good surgeon who has done thousands of cataract and ICL surgeries. Invest in a good doctor.

**Day 0**

Day of was of course very blurry. The post op eye exam was 20/40 ish. I slept most of the day due to the Valium they give you. Even so, on the way home I could already see fairly well.

**Day 1**

Next day I woke up with no cloudiness and could see well enough to drive to my follow up. I could read street signs but not license plates. Vision was 20/22 in one eye and 20/28 in the other. I took it easy the rest of the day, listening to audio books and wearing sunglasses.

**Day 8**

At the one week I was 20/20 (probably better but they didn’t test beyond that). My eye pressure and vault look great according to the doctor. He said I could resume all normal activities.

**Side Effects**

The side effects most people mention have been very minimal for me, except I do see the rings when there is off-angle bright (non-diffuse) light. This is rarely a problem but my first trip to the grocery store was bad. The lights above are all spaced so that no matter which way you look the rings are in your vision. I had to look down somewhat to avoid them. The next visit was better, but rings were still visible. I think my mind is adjusting / ignoring them.

Otherwise I don’t really see any other artifacts like sunbursts, ghosting, etc. on occasion I’ve temporarily seen it with some blue LED point lights in pitch dark, or noticed a glow around LEDs while my eyes adjust. Otherwise no issues.

**The Good**

My distance vision is phenomenal, crisp, clear and vibrant. Probably better than I’ve ever seen. This came in very quickly and improved even more each day. Being able to see and not worry about glasses contacts is already great. I have absolutely only good things to say about my distance vision with EVO.

**The Bad / Issues**

My issue is that reading text is still blurry. Anything at normal reading distance (books, phone, monitors etc). is an issue. I know that you lose the ability to se very close to your face (I’m not talking about that). Screens, especially smart phone, are much worse than books. Simply put, the text is blurry, not crisp, and hard to read. This is a big issue as I work on the computer all day, and I spend a lot of my life on screens. If anyone experienced similar 1-2 weeks out, please let me know and whether it got any better! I’m wondering if this is an issue with my eyes learning to focus, a bit of dry eye, or a combo?

Note that generally TV screens are fine since they are usually more than 5ft out - no problems generally. White text on black backgrounds can sometimes be a bit harsh but nowhere near the issues I have with monitors and smartphone. Overall the TV experience has been good.

Hi guys,

I’m looking for advice or experiences with vision correction for high hyperopia and astigmatism.

My contact lens prescription is:

Right eye: +8.50 SPH, -4.25 CYL
Left eye: +6.50 SPH, -4.25 CYL

My left eye is more dominant than the right eye, so i have a bit of amblyopia

I know I’m probably not a good LASIK/PRK candidate because of the high prescription. I’ve been reading about hyperopic Toric ICL, but it seems less common and more complicated than ICL for myopia.

My main questions are:

1. Is hyperopic Toric ICL realistically possible with numbers like mine?
2. How risky is it compared to regular myopic ICL?
3. Would amblyopia limit the final result a lot?
   4.Are there any alternatives or new technologies?
4. If there is residual astigmatism after ICL, how is it usually fixed?

I know I need a full eye exam and measurements, but I’m trying to understand if correcting my vision without major side effects is realistic.

Any experience or professional input would be appreciated.

I appreciate everyone who helps🙏🏻

I’ll be having ICL surgery soon and I have two cats at home

I’m planning to sleep in a separate room and avoid touching in the first days, but they’ll still be in the same house

How careful do I really need to be during the first week?

I had a -7 prescription in both eyes, and for years I juggled between glasses and contact lenses — neither of which ever felt truly adequate. My glasses were constantly dirty, scratched, or expensive to replace. Contacts came with their own set of frustrations: switching them out for sports, remembering to remove them before sleep, carrying cleaning solution everywhere, and if I'm honest, not always keeping up with the hygiene they demand. I also couldn't easily wear sunglasses with glasses, which was its own small but persistent annoyance. LASIK wasn't an option for me since my corneas were too thin, so ICL was the natural path forward.

Six months ago, I underwent my first ICL surgery at Charité in Berlin. Shortly after, I noticed that my left eye had significantly worse vision than my right, which led me back in for a revision surgery about a month later. While the repeat procedure was frustrating — especially the numbing injections, which I found particularly uncomfortable — I came to understand it was necessary. It turned out that the wrong lens size had been selected initially. The surgeon confirmed this with confidence; in fact, upon making the incision she remarked that I have unusually large eyes, which explained the sizing error.

The recovery process was manageable, though having two surgeries meant a combined three months of downtime, which left me feeling restless and unmotivated. Following recovery, it took roughly another three months to fully adjust — my left eye had a subtle difference in its field of view, most noticeable when stepping into bright sunlight in the morning.

There was no single dramatic "wow" moment of clarity. Instead, good vision just quietly became my new normal — and in many ways, that seamless transition is the best outcome I could have asked for. It was only once I stopped noticing my lenses entirely that my appreciation for the procedure truly set in.

I also experienced halos around lights initially, but once I understood what was causing them, they stopped bothering me. They've diminished significantly over time, and wearing sunglasses has helped both reduce them and better protect my vision overall.

Six months on, my vision is essentially perfect and all follow-up appointments have gone smoothly. The total cost came to around €3,400 — and given what I was spending on glasses, contacts, and solutions over the years, not to mention the daily inconvenience, it was absolutely worth it financially. If you're considering ICL, my honest advice is straightforward: if you can comfortably afford it, it's worth serious consideration. The road isn't always perfectly smooth, as my experience shows, but the destination is more than worth it.

This content was generated by AI
I wrote this using claude, I chucked in my points and read this, agreed and copied it here.

Feel free to ask questions

I’m about 3 weeks out from my EVO ICL surgery. I had a great experience. I really thought a long time about it, since it’s my eyeballs, and I only have two of them! I’ve been wearing glasses since 1st grade and contacts since 5th grade. I’m about a -13 (😭I know) with slight astigmatism. I wore monthly toric lenses for a super long time but about 10 years ago I had to switch to daily lenses but none were produced in my strength, so I went without astigmatism correction. More recently, with increased computer work and some other changes, the headaches were too much without the astigmatism correction. Wearing glasses for long periods of time give headaches due to the weight. So I didn’t really have any other options.

It probably goes without saying, I wasn’t a candidate for any other vision surgery due to my extremely high myopia. I had a retina specialist check, and I did have some minor lattice on the outer portion of one eye. But it was minor, we had been aware of it and monitoring it. She didn’t feel that it needed to be addressed or that it would impact the surgery specifically.

Surgery was great, very similar to others experiences. I had ketamine/versed. I remember everything. The first eye, I would describe it as feeling like I was in an attic that was bright and white with slowly changing colorfully shapes in the middle I was watching, the second eye-though not “bad” or painful- I was more aware, they did give me another dose, it was probably less than the first since the surgery in general is pretty quick. Visually, it was darker, same shapes changing but I was more aware of what they were doing and they kept telling me to look at the light (I was trying! I didn’t have to try with the first eye) so I’m guessing I was less sedated than the first eye. I could see the len sort of open up in my eye. Everything was like looking through oil the first day and my eyes were sensitive. I thought it might trigger a migraine, but I didn’t get one, it was more just an eye- ache.

For anyone that’s had ICL or lasik, or any other vision correction surgery… did you experience this for a few days or maybe it’s just me? 😆 I felt like a sadness. Not sad about the experience or the result- those were great. But just sad that, I know it sounds weird- I couldn’t turn my eyes “off”.
The only thing I can think to maybe compare it to- people with cochlear implants often will take breaks and turn it off. Turning it off sort of reduces the stimulation coming in to give themselves a break. I feel like when I took my contacts out, and more so when I took my glasses off, it was a way to reduce stimulation from the outside. Not that I could ever walk around without glasses! At a -13, you can’t do anything or see anything without them! But I guess when I had a headache it went to bed and took them off it forced myself to do nothing. You can’t see your phone, or a book, nothing- so you’re forced to just close your eyes. It felt weird to not have that option. I can’t just take my contacts out or glasses off. Pretty much since my earliest memory I’ve had the ability to do that, and also had to worry about where my glasses or contacts were.

Now, the feeling of that, almost 3 weeks out has nearly passed. I don’t regret the surgery at all, and I would do it again in a heartbeat. I’ve had elective cosmetic surgeries before, and I’ve experienced similar feelings- just a sadness feeling- though I’ve also had great experiences and outcomes. It seems to just be a fleeting feeling for a few days-week or so. I’d heard others have experienced the same with cosmetic surgery but I don’t think I’ve heard of anyone talk about it with vision correction surgery.

I wouldn’t have changed my mind, I just wonder if others have had that feeling. I guess, knowing that I might experience it would be nice, so when I did, I’d expect it and it wouldn’t catch me off guard like it did.

ICL offers a unique advantage for individuals with Keratoconus. Other procedures such as Lasik remove corneal tissue to reshape the eye. For corneas that are already structurally compromised, this can potentially accelerate the Keratoconus and make it worse. However, ICL does not involve any removal of corneal tissue, it preserves the existing corneal architecture. This makes it much safer option with Keratoconus. But there are some things to consider.

ICL doesn’t “cure” Keratoconus. It can only correct the prescription. And so one of the most important requirements for ICL is having a stable prescription. Because Keratoconus is a progressive condition, placing an ICL into an eye that is still changing is a sure way to lead to the development of residual prescription in the future. So it’s critically important to make sure the Keratoconus is done progressing. If you are at risk for progression you may need corneal cross-linking (CXL) prior to ICL surgery to stop the progression of the Keratoconus to ensure that the prescription doesn’t change after ICL.

Additionally, it’s also important to understand limitations regarding irregular astigmatism. Toric ICL lenses correct what’s known as “regular” astigmatism. This is the type of astigmatism that glasses can correct. Irregular astigmatism comes from an asymmetric shape to the cornea - such as the “cone-shaped” cornea in Keratoconus. ICL can’t correct that irregular shape. (However, of note there are other surgeries that are designed to reduce that irregular shape in Keratoconus to reduce this irregular astigmatism; ICL isn’t one of them though).

If you need hard contact lenses or scleral contact lenses to get good vision, you probably have a lot of irregular astigmatism and ICL won’t be able to match those lenses (but it can still reduce the amount of prescription that you have). But if you see well with glasses or soft contact lenses, you likely don’t have much of this irregular astigmatism and ICL can work well for you.

Nothing is 100% accurate and even though ICL does a pretty nice job, there are still times when one may have some residual prescription or astigmatism after ICL surgery. Usually somewhere around 1-2% of cases. This residual prescription can blur vision and be bothersome; but there are ways to correct it.

The most common method by far is doing a laser vision correction procedure such as Lasik or PRK. You may be thinking “But I wasn’t a candidate for those procedures”. If you had a high prescription prior to ICL, this would be because the high treatment would need to remove a significant amount of cornea tissue. And removing too much corneal tissue can lead to problems such as a weakening of the cornea called ectasia.

But after ICL, if you have a residual prescription, it will be a much smaller prescription and require very little corneal tissue to treat. This makes lasik and PRK a very easy and highly accurate way to get rid of that remaining prescription.

But not everyone is suited for a laser enhancement procedure. The cornea may show suspicious signs of weakness or have bad dry eye. And the ICL is removable. So an alternative way to correct things is to exchange out the ICL lens for one with a different power to correct the prescription. But if lasik or PRK can be performed, it will usually be able to more accurately get rid of the small residual prescription, so ICL exchange for residual prescription is less commonly done.

Regardless of the approach, it is pretty common for the surgeon to give some time to allow the prescription to stabilize in order to ensure the treatment is the most accurate.

hi everyone,

IM supposed to use my eye drops for another five days, it’s the Sandoz Prednisolone Eye Drops. I finished them early, and the clinic is closed on weekends so I’m not sure what to do. will this affect my eyes?

I have basically been researching a complex prescription high myopia and astigmatism. I narrowed down my search between Prague and Seoul and was shocked at allegedly some of the best clinics happy to take another clinics measurements for Lens sizing and vault size.

I know of car mechanics that will not take another garages diagnostics, but here we are for simple convenience on lens ordering and timelines eye clinics prepared to take another unknown clinics assessment.

What was even more surprising? Was these clinics used different equipment and methodologies for optimal lens sizing and vault clearances but they’re happy just to take WTW and pupil size and no mention of sulcus to sulcus and methodology or nomograms used.

The standard response is get the measurements done in your home country and that way you will only have to visit once for surgery rather than consultation followed by lens ordering