Am I too old for ICL implantation?

Newer ICL implants work well in older patients

ICLs work a bit like contact lenses implanted into your eye. ICL implantation is an effective and safe way of correcting your vision, and a very good alternative if your spectacle prescription is out of range for safe laser vision correction. Over half a million ICLs have been implanted since 1992, and every year the number of patients choosing this option increases.

The American Food and Drug Administration (FDA) approves ICLs for patients 21-45 years of age. As with many of the guidelines used subsequently to steer procedure choice, this age range is based on the age group studied in clinical safety trials. But what happens if you are over 45?

The short answer is nothing. Age related change in the eyes is gradual, and there are strong arguments for using ICLs, particularly for patients with high levels of short sight (myopia) well into the 50s.

Most people start to notice the effects of aging in the natural lens in their 40s. The lens gets less flexible, and reading vision deteriorates. But there is plenty of flexibility left, and newer ICLs with an extended depth of focus will soon be available to help you with the near range as you move on into your 50s.

Later in life, the lens gets less clear. A lens that is misty enough to cloud your vision is called a cataract. No-one gets a clearer lens as they age, and the main long-term risk of ICL implantation is developing cataracts sooner than you might do anyway. This is why refractive lens exchange (RLE), an operation identical to modern cataract surgery, is often offered if you are highly myopic and the wrong side of 45.

But latest generation ICLs encourage natural fluid circulation in the eye, and do not appear to accelerate cataract development. Also, important new research from France shows that the risk of retinal detachment after cataract surgery (or RLE) diminishes with age. ICL implantation presents no special problems for future cataract surgery, and does not increase your risk of retinal detachment. Even if it is just a stepping stone to cataract surgery later in life, ICL implantation is probably a safer option for your eyes than RLE for patients in mid-life with high myopia.