If your prescription is beyond the safe limits for LASIK, your cornea is too thin, or you prefer a reversible alternative, ICL (Implantable Collamer Lens) surgery could be an excellent option. This procedure involves placing a soft, biocompatible lens inside the eye—without removing corneal tissue, using corneal lasers, or causing permanent structural changes.
Dr. Naren Shetty at Narayana Nethralaya is an expert in phakic IOL implantation, including the latest EVO ICL—the most advanced implantable lens technology worldwide, featuring a central port that removes the need for preoperative laser procedures.
-20D
Maximum myopia correctable with ICL
100%
Reversible - lens can be removed
No cornea
Tissue removed - cornea untouched
20 min
Procedure time per eye
What Is a Phakic IOL?
A phakic intraocular lens (IOL) is an artificial lens implanted inside the eye while preserving the eye’s natural crystalline lens—unlike cataract surgery, where the natural lens is removed. The term “phakic” indicates that the natural lens remains in place.
The lens is positioned in the posterior chamber, between the iris and the natural lens, functioning like a permanent internal contact lens that focuses light accurately onto the retina.
Posterior Chamber ICL
Placed between iris and natural lens. Most common type. EVO ICL falls here.
EVO ICL - The Latest Generation Lens Technology
The EVO ICL (by STAAR Surgical) is the current gold standard in phakic IOL technology. It represents a major evolution over earlier ICL designs.
Central Port Design (KS-Aquaport)
EVO ICL features a 360-micron central hole that allows natural aqueous humour circulation. This eliminates the need for a preparatory peripheral iridotomy (PI) laser - previously a mandatory pre-operative step.
- ✓No pre-operative YAG laser required
- ✓Natural fluid circulation maintained
- ✓Reduces risk of elevated eye pressure
- ✓Simpler patient experience
Collamer Material
The lens is made from Collamer - a proprietary collagen-acrylate co-polymer that is inherently biocompatible. The eye does not recognise it as foreign material, resulting in extremely low rates of lens-related inflammation.
- ✓UV-blocking - protects the retina
- ✓Does not cause lens-induced inflammation
- ✓Remains soft and flexible inside the eye
- ✓Over 20 years of clinical safety data
EVO Toric ICL
The EVO Toric ICL corrects both myopia and astigmatism simultaneously. Astigmatic correction is built into the lens optic, providing sharp vision without residual cylindrical error.
- ✓Corrects astigmatism up to 6D
- ✓Rotational stability in the posterior chamber
- ✓Single implant for both power and cylinder
- ✓Suitable for patients not eligible for toric LASIK
EVO+ ICL (Larger Optic Zone)
EVO+ features a 6mm optical zone (compared to 5.5mm in standard EVO), designed for patients with large pupils. It reduces the risk of halos and glare under dim light conditions.
- ✓Ideal for patients with large pupils
- ✓Reduced glare and halos at night
- ✓Better night driving quality
- ✓Preferred for high myopia correction
The ICL Procedure - Step by Step
Comprehensive pre-operative evaluation
Corneal topography, anterior segment OCT, white-to-white (WTW) measurement, endothelial cell count, anterior chamber depth, and refraction. These determine lens size and power.
ICL sizing and ordering
Each EVO ICL is custom-manufactured to your eye's exact measurements. The lens is ordered and typically delivered within 3 weeks.
Anaesthesia
Topical anaesthetic drops are used. The procedure is performed under local anaesthesia - no general anaesthesia required.
Lens insertion
A 3.2mm microincision is made at the corneal periphery. The folded EVO ICL is injected through this tiny opening using a specialised injector cartridge.
Positioning
The lens self-unfolds in the posterior chamber and is positioned behind the iris using microsurgical instruments. No sutures are required.
Post-operative review
Eye pressure, lens position, and vision are checked the following day. Medicated drops for 4 weeks. Vision stabilises rapidly within 24-48 hours.
Who Should Consider ICL?
✅ Ideal ICL Candidate:
- • High myopia: -3D to -20D
- • Cornea too thin for LASIK
- • Dry eye concerns (cornea untouched)
- • Age 21-45 years
- • Wants reversible correction
- • Adequate anterior chamber depth (≥2.8mm)
- • Healthy endothelial cell count
❌ Not Suitable For ICL If:
- • Shallow anterior chamber (< 2.8mm depth)
- • Low endothelial cell count
- • Active uveitis or intraocular inflammation
- • Uncontrolled glaucoma
- • Previous corneal surgery (certain cases)
- • Age under 21 (prescription still changing)
- • Very small white-to-white diameter
Frequently Asked Questions - ICL Surgery
Is ICL surgery permanent?+
The vision correction is intended to be permanent, but the lens is fully reversible and can be removed or exchanged if needed in the future. This makes ICL unique among refractive procedures.
Will I feel the ICL lens inside my eye?+
No. The EVO ICL is positioned behind the iris where it cannot be seen or felt. Most patients forget it is there.
Does ICL surgery hurt?+
No. The procedure is performed under topical anaesthetic drops. You may feel mild pressure during surgery but no pain.
Can ICL cause cataracts?+
Older ICL designs occasionally caused anterior subcapsular cataracts due to contact with the natural lens. The EVO ICL is specifically designed with a vault to avoid any contact with the natural lens, significantly reducing this risk.
How long does EVO ICL last?+
EVO ICL is designed for lifelong use. Long-term studies show excellent safety and stability over 10-15 years. Natural cataract surgery in older age may require lens removal at that time.
Can I have ICL if I've already had LASIK?+
In some cases, yes - piggyback ICL after LASIK is performed to correct residual myopia. Dr Naren Shetty will evaluate suitability at consultation.
What is the recovery time for ICL?+
Vision improves dramatically within 24 hours. Most patients are functionally independent by Day 1. Full stabilisation occurs over 1-4 weeks.