How it works
Nothing is lasered and no corneal tissue is removed. After numbing (and usually a sedative), the surgeon makes an opening of 2 to 3 mm at the edge of the cornea, slides the folded lens in, and it unfolds behind the coloured iris. You can't see or feel it, and it needs no cleaning. Eyes are done on the same day or about a week apart.
Who it suits
Adults over 21 with a stable prescription that is high: implantable lenses treat short sight up to about -18, long sight up to about +10 and astigmatism up to about 4.5. They also suit moderate prescriptions where the cornea is thin, irregular or the eyes are prone to dryness, because the cornea is left alone. A scan checks there is enough space inside the front of the eye.
Who should look at something else
- Anyone under 18. Laser eye treatment is for adults, and most clinics want you a little older, once the prescription has settled.
- Anyone whose prescription changed in the last year. Wait until it has held steady.
- Pregnancy and breastfeeding, when hormones can change the prescription. Wait until things have settled.
- Keratoconus, or a cornea the scans show is too thin or irregular for laser.
- Uncontrolled diabetes, or an autoimmune condition or medicine that affects healing, without extra assessment first.
- A cataract, glaucoma or repeated inflammation inside the eye.
- Not enough room in the front of the eye on the scan.
- People over about 50, where lens replacement often makes more sense.
Recovery
Most people see well enough to go back to work the day after. Blurring, light sensitivity, mild discomfort and glare at night are common at first. There is a check the next day and again a few weeks later. Don't drive until the clinic confirms you meet the standard.
The risks, honestly
Every operation inside the eye carries a small risk: infection, a cataract forming earlier than it would have, retinal detachment, and under- or over-correction. The lens can be taken out or swapped if needed, which laser treatment can't offer. Ask the surgeon for their own figures.
What it costs
€2,900 to €3,900 per eye, so €5,800 to €7,800 for both, usually including follow-up for the first months. Like laser, it treats defective eyesight rather than being routine eye care, so it should qualify for tax relief at 20%. Keep every receipt.
Choosing a surgeon
Ask for the surgeon's name and check it on the Medical Council's register. By law a doctor can only practise independently as a specialist with specialist registration, and an eye surgeon should be on the Specialist Division of the register in ophthalmology.
The Royal College of Ophthalmologists advises taking at least a week after the consultation with your surgeon before you decide, and checking that any deposit is refundable if you change your mind.
Questions people ask
Is an implantable contact lens permanent?
It is designed to stay in for good, but it can be removed, for example if you need cataract surgery later in life.
Will I feel the lens?
No. It sits inside the eye behind the iris. You can't see or feel it and it needs no care.
Is ICL better than laser?
For high prescriptions and thin corneas it is often the safer choice. For everyday prescriptions, laser is simpler and costs less.
How long does the operation take?
Usually under half an hour per eye, with a few hours at the clinic in all.