Why Is ICL Surgery Popular in Asian Countries?

ICL surgery, also known as implantable collamer lens surgery, has become increasingly popular across many Asian countries over the past two decades. This includes countries such as Japan, South Korea, China, Singapore, and parts of South Asia, where demand for advanced vision correction procedures continues to grow.

One of the main reasons for this popularity is the high prevalence of myopia in many Asian populations. In some urban areas, a large proportion of teenagers and young adults require glasses or contact lenses, and higher levels of myopia are more common than in many other parts of the world. This creates strong demand for effective long-term vision correction options.

ICL is often considered an attractive solution because it can correct moderate to high prescriptions without removing or reshaping corneal tissue. This makes it particularly relevant for patients who may not be suitable candidates for laser eye surgery due to factors such as prescription strength or corneal thickness.

At the same time, advances in diagnostic technology, lens design, surgical techniques, and long-term safety data have increased confidence in the procedure. However, despite its growing popularity, ICL is not suitable for everyone, and a thorough eye assessment is always required to determine whether it is the safest and most appropriate option for your individual eyes.

What Is ICL Surgery?

ICL surgery involves placing a thin, soft prescription lens inside your eye to correct vision. The natural lens remains in place, and the implanted lens works alongside it to focus light more accurately onto the retina. Because the natural lens is preserved, ICL is known as a phakic intraocular lens procedure.

Unlike LASIK, PRK, or SMILE, ICL surgery does not reshape or remove corneal tissue. Instead, the vision correction is achieved by the implanted lens itself. This can make it a suitable option for patients who may not be ideal candidates for corneal laser surgery due to factors such as high prescriptions or corneal thickness concerns.

ICL is considered a refractive surgery option for selected patients with myopia, hyperopia, and astigmatism. However, suitability depends on a detailed assessment of your eye anatomy, overall eye health, and whether there is enough space inside the eye to safely accommodate the lens.

High Myopia Rates in Asia

One of the main reasons ICL surgery has become so popular in Asia is the high prevalence of myopia across the region. Numerous studies have shown that East and Southeast Asia have some of the highest rates of short-sightedness in the world, particularly among teenagers, university students, and young adults.

In many urban areas, a large proportion of the population requires glasses or contact lenses for distance vision, and high myopia is especially common. As prescriptions become stronger, patients are more likely to explore long-term vision correction options rather than relying solely on spectacles or contact lenses.

Higher prescriptions can also make laser eye surgery more challenging, particularly when corneal thickness or treatment range becomes a concern. For this reason, ICL is often discussed as an alternative option for suitable patients with moderate to high myopia, contributing to its growing popularity throughout many Asian countries.

Why High Myopia Matters for Treatment Choice

If you have high myopia, it can make laser eye surgery more challenging because stronger prescriptions usually mean more corneal tissue needs to be removed to achieve the level of correction you need. In some cases, this can raise concerns about whether enough corneal thickness will remain afterwards, which is important for maintaining long-term corneal stability.

ICL surgery avoids this issue because it does not involve reshaping or removing any corneal tissue. Instead, a specially designed prescription lens is placed inside your eye, allowing your vision to be corrected while keeping your natural corneal structure intact.

This is why you may find ICL is particularly suitable if you have moderate to high myopia and may not be an ideal candidate for LASIK, PRK, or SMILE. For suitable patients, it can offer effective vision correction with a non-corneal and potentially reversible alternative to laser eye surgery.

Age and Lifestyle Factors

ICL surgery is often particularly popular among young adults in Asia. Many people in this age group have stable prescriptions, healthy eyes, and are seeking a long-term solution to reduce their dependence on glasses or contact lenses before age-related eye conditions become a factor.

In many Asian countries, intensive educational demands and screen-based lifestyles begin at a young age and have been associated with higher rates of myopia development. As a result, a significant number of young adults reach an age where they begin exploring refractive surgery options to improve their quality of life and visual freedom.

Because ICL provides vision correction without reshaping the cornea, it is often discussed once a patient’s prescription has stabilised and a full eye assessment confirms suitability. For appropriate candidates, it can offer a predictable and long-lasting option for correcting moderate to high levels of myopia.

Limitations of Glasses and Contact Lenses

Glasses and contact lenses remain effective ways to correct vision, and many people use them successfully for years. However, they may not suit everyone’s lifestyle or visual needs. For some people, the daily maintenance, discomfort, or inconvenience can lead them to consider surgical alternatives such as ICL.

• Daily Dependence Can Be Inconvenient: You may find wearing, cleaning, and managing glasses or contact lenses frustrating, especially during busy routines.
• Contact Lens Intolerance Can Develop: Some people experience discomfort, dryness, irritation, or reduced wearing time with contact lenses.
• Lifestyle Considerations Matter: Activities such as sports, travel, long working hours, or active lifestyles may make dependence on corrective eyewear less convenient.
• Dry Eye Symptoms Can Be a Challenge: If contact lenses worsen dryness or discomfort, you may start looking for alternative ways to correct your vision.
• ICL Reduces Reliance on Daily Correction: ICL can provide clear vision without the need for daily contact lens wear or constant dependence on glasses.

Overall, glasses and contact lenses remain excellent options for many people, but they are not always the most convenient solution. If you are finding them difficult to wear or manage, ICL may be worth discussing as a potential alternative. The right choice depends on your eye health, prescription, and personal lifestyle preferences.

Corneal Thickness Concerns

Corneal thickness is an important factor when you are considering any form of refractive surgery. If you have thinner corneas or a very high prescription, you may not be suitable for procedures such as LASIK or SMILE because these treatments work by removing corneal tissue to reshape your eye.

In these situations, you may find ICL surgery is considered as an alternative because it does not involve altering the shape of your cornea. Instead, a specially designed lens is implanted inside your eye to correct your prescription while leaving your corneal structure largely unchanged.

This makes ICL a valuable option for you if you are not an ideal candidate for laser vision correction. However, your suitability still depends on a full eye assessment, including factors such as anterior chamber depth, endothelial cell count, eye pressure, and your overall eye health not just corneal thickness alone.

Keratoconus Awareness and Screening

If you have keratoconus, it means your cornea becomes thinner and gradually changes shape, leading to an irregular surface over time. This is an important consideration when you are thinking about refractive surgery because procedures like LASIK are generally not recommended if your cornea is unstable or showing signs of progressive thinning.

In many Asian eye clinics, you will find that keratoconus screening is a standard part of the refractive surgery assessment. Advanced corneal imaging helps detect early or suspected keratoconus, allowing potential issues to be identified before any vision correction procedure is carried out.

If laser eye surgery is not suitable for you due to corneal concerns, ICL surgery may sometimes be discussed as an alternative option. However, this should only be considered after a thorough corneal evaluation and a complete assessment of your eye health and overall suitability for surgery.

Advanced Diagnostic Technology

Another factor contributing to the popularity of ICL surgery in Asia is the widespread availability of advanced diagnostic and imaging technologies. When you visit a specialist eye clinic, you may find tools such as corneal topography, corneal tomography, anterior segment OCT, and detailed biometric measurements are used to assess your eye in a high level of detail.

These technologies help your surgeon determine whether you are more suitable for laser vision correction or ICL surgery. They also provide important information about corneal shape, anterior chamber depth, lens position, and other anatomical features that influence your treatment plan.

With more accurate diagnostic data, your surgeon can make more personalised decisions about your care. This improves confidence in patient selection and helps ensure you are guided towards the safest option, with more predictable outcomes and better long-term visual results.

Safety Profile and Long-Term Outcomes

If you are considering ICL surgery, it is helpful to understand that it has been widely studied over many years, and the available evidence generally shows good visual and refractive outcomes in appropriately selected patients. Advances in lens design and surgical techniques have also improved the safety profile of modern ICL models compared with earlier generations.

Long-term studies suggest that you can achieve stable vision correction, high levels of satisfaction, and strong predictability when the lens is correctly sized and you attend regular follow-up appointments. Many patients continue to enjoy excellent vision years after their procedure.

However, you should also keep in mind that ICL is still an intraocular surgery, so it is not considered routine or risk-free. Careful pre-operative planning, precise lens sizing, and ongoing monitoring are essential to maintain safety and to detect any potential issues over time, such as changes in eye pressure, lens position, or vault.

Reversibility Factor

One reason many patients and surgeons consider ICL surgery is that the implanted lens can be removed or exchanged if necessary. Unlike laser eye surgery, which permanently reshapes the cornea, ICL provides a level of flexibility because the lens itself is not a permanent alteration to the eye’s natural structure.

This potential reversibility can be reassuring, particularly for younger patients who may value having future options available as their vision or eye health changes over time. For some people, knowing that the lens can be removed if required is an important part of the decision-making process.

However, reversibility should not be mistaken for simplicity. ICL remains an intraocular surgical procedure that requires careful planning, precise implantation, and ongoing follow-up. The decision to proceed should always be based on suitability, safety, and a thorough understanding of both the benefits and potential risks.

Increasing Awareness and Accessibility

If you look across many Asian countries, you will notice that awareness of ICL surgery has increased significantly over the past decade. You are more likely to come across information about the procedure through medical conferences, patient education programmes, online resources, and refractive surgery marketing, all of which help you better understand where ICL may fit among your vision correction options.

As diagnostic technology, lens design, and surgical techniques have continued to improve, you can also see that ICL outcomes have become more predictable and well documented. This has given both surgeons and patients greater confidence in the procedure, encouraging more eye clinics to include ICL as part of their refractive surgery offerings.

With improved accessibility and growing awareness, ICL has become increasingly popular alongside established procedures such as LASIK, PRK, and SMILE. Today, you may find that many patients actively consider ICL during their consultation process, particularly if they have higher prescriptions or are not ideal candidates for laser eye surgery.

Cultural Preference for Vision Correction

If you look at vision correction trends in some cultures, you may notice a strong preference for achieving clear vision without depending on glasses or contact lenses. For you, factors such as education demands, professional expectations, active lifestyles, and everyday convenience can all increase interest in surgical vision correction.

Many patients value the freedom that comes with reduced reliance on corrective eyewear, especially in academic, business, and social settings where you may feel that clear unaided vision offers practical advantages. This can lead you to consider long-term vision correction options more seriously.

In this context, you may find that ICL surgery is often viewed as a premium or advanced option. Its ability to treat moderate to high prescriptions, preserve your corneal tissue, and deliver high-quality visual outcomes contributes to its appeal if you are seeking an alternative to glasses, contact lenses, or laser eye surgery.

Suitability Still Depends on Eye Anatomy

Despite its growing popularity, ICL surgery is not suitable for everyone. Whether you are a good candidate depends on detailed measurements of your eye anatomy, including anterior chamber depth, endothelial cell count, eye pressure, corneal shape, lens position, and retinal health.

Two people may have very similar prescriptions but receive completely different recommendations after a full assessment. This is because the safety and success of ICL surgery depend on having enough internal space for the lens and meeting a range of anatomical and health criteria.

For this reason, a thorough pre-operative evaluation is always essential. Detailed scans and examinations help your surgeon determine whether ICL is the safest and most effective option for your eyes, or whether another form of vision correction may be more appropriate.

Comparison With LASIK and SMILE

LASIK, SMILE, and ICL are all established vision correction procedures, but they work in different ways. LASIK and SMILE improve vision by reshaping your cornea, while ICL corrects vision by placing a specialised lens inside your eye. The most suitable option depends on your prescription, corneal measurements, and overall eye health.

• Different Treatment Methods: LASIK and SMILE reshape the cornea using laser technology, whereas ICL works by implanting a lens inside the eye.
• LASIK and SMILE for Suitable Corneas: These procedures may be preferred if you have a lower prescription and healthy corneal thickness and shape.
• ICL for Higher Prescriptions: ICL is often considered when your prescription is higher or when corneal measurements make laser surgery less suitable.
• Corneal Limitations Matter: Thin corneas, dry eye concerns, or abnormal corneal scans may influence whether laser treatment is appropriate.
• No Single Best Procedure: Each option has its own benefits, risks, and limitations, so treatment should be tailored to your individual eyes.

Overall, choosing between LASIK, SMILE, and ICL is not about which procedure is most popular but which one is most appropriate for you. A detailed eye assessment helps determine the safest and most effective option based on your prescription, corneal health, and long-term visual needs.

Cost and Long-Term Value

If you are considering ICL surgery, you will often find that it is more expensive than laser eye surgery. This is because it involves a specially designed lens, advanced diagnostic testing, and a high level of surgical expertise. The upfront cost can feel significant, but many patients still consider it a worthwhile investment when they are suitable candidates.

Some people see ICL as offering strong long-term value because of its high-quality visual outcomes, preservation of your corneal tissue, and the fact that the lens can be removed or exchanged if necessary. These features can make it particularly appealing if you are not an ideal candidate for laser vision correction or if you prefer a more reversible approach.

In many Asian urban centres, you will also notice growing demand for premium vision correction options, with patients often willing to invest in procedures that improve convenience and reduce dependence on glasses or contact lenses. However, while cost is an important factor for you to consider, safety, suitability, and long-term eye health should always come first when you are making a decision about vision correction.

Post-Surgery Outcomes and Satisfaction

If you look at research on ICL surgery, you will often find high levels of patient satisfaction, especially among people with moderate to high myopia. You may notice that patients commonly report clearer vision, reduced dependence on glasses or contact lenses, and strong visual quality in everyday situations, including night-time driving and low-light conditions.

A key reason for this satisfaction is that ICL surgery can deliver excellent visual outcomes while preserving the natural shape of your cornea. For suitable candidates, it often provides predictable and stable vision correction, along with a relatively quick recovery period compared with more invasive expectations.

However, even after successful surgery, you still need ongoing eye care. Regular follow-up appointments are important for monitoring eye pressure, ICL vault, lens position, and your overall eye health. These check-ups help you and your surgeon identify and manage any potential issues early, supporting the best possible long-term results.

Risks and Considerations

Like all surgical procedures, ICL surgery carries potential risks and complications. These may include raised eye pressure, cataract formation, lens rotation, inflammation, abnormal vault, or the need for additional procedures or vision correction after surgery.

The good news is that careful patient selection and thorough pre-operative assessment can significantly reduce these risks. This is why the consultation process is so detailed and includes extensive measurements, imaging, eye pressure checks, and evaluation of your overall eye health.

Before deciding on ICL surgery, you should be given clear information about the potential benefits, risks, alternatives, and expected outcomes. An informed decision is an important part of achieving the safest and most appropriate result for your individual eyes.

Why Demand Continues to Grow in Asia

Demand for ICL surgery continues to grow across many Asian countries due to a combination of factors, including high rates of myopia, advances in surgical techniques, improved lens technology, and a growing body of long-term safety and effectiveness data. As more patients become aware of their vision correction options, interest in ICL has increased.

Younger generations are also generally more open to surgical vision correction than previous generations. Many people seek greater freedom from glasses and contact lenses for work, education, sports, and everyday convenience, making procedures such as ICL increasingly attractive.

As diagnostic technology, lens sizing methods, and surgical planning continue to improve, demand is likely to increase further. Greater awareness among both patients and eye care professionals is expected to play an important role in the continued growth of ICL surgery across Asia.

When to Consider ICL Surgery

You may consider ICL surgery if you have moderate to high myopia, thin corneas, contact lens intolerance, or if laser eye surgery such as LASIK, PRK, or SMILE is not the most suitable option for your eyes. Because ICL does not remove corneal tissue, it can be an alternative for some patients who are not ideal candidates for laser vision correction.

Before any decision is made, you should have a thorough assessment of your eyes. This typically includes detailed measurements of your prescription, anterior chamber depth, corneal health, eye pressure, endothelial cell count, and retinal health, along with advanced imaging and sizing calculations.

If you are considering ICL surgery in London, your consultation should clearly explain why the procedure is suitable for you, what benefits and risks apply to your specific eyes, and whether any alternative treatments may be more appropriate. The decision should always be based on your individual eye measurements rather than prescription alone.

FAQs:

1. Why is ICL surgery more popular in Asian countries than in other regions?
   ICL surgery is more popular in many Asian countries because rates of moderate to high myopia are significantly higher compared with global averages. This creates a larger patient group who may need stronger vision correction options beyond standard laser procedures.
2. What makes ICL suitable for people with high myopia?
   ICL can correct higher prescriptions without removing corneal tissue, which is often a limitation in laser eye surgery. This makes it a preferred option for patients with stronger prescriptions where LASIK or SMILE may not be ideal.
3. Is the popularity of ICL in Asia related to lifestyle or education?
   Yes, lifestyle factors such as intensive education, prolonged screen use, and early onset of myopia contribute to higher demand. As a result, more young adults explore long-term vision correction options like ICL.
4. How does ICL differ from LASIK and SMILE?
   Unlike LASIK and SMILE, which reshape the cornea, ICL involves placing a lens inside the eye without altering corneal tissue. This makes it suitable for patients who may not qualify for corneal laser surgery.
5. Why is high myopia a key reason for ICL demand in Asia?
   High myopia is more common in East and Southeast Asian populations. Since laser procedures have limits based on corneal thickness and prescription strength, ICL becomes a more widely considered alternative.
6. Is ICL surgery considered safer than laser eye surgery?
   Both ICL and laser procedures are considered safe when performed on suitable candidates. ICL has a strong safety profile in modern practice, but it is still an intraocular surgery and requires careful assessment and follow-up.
7. Why do younger patients in Asia prefer ICL?
   Younger patients often prefer ICL because it is reversible, does not permanently alter the cornea, and can provide long-term visual stability. It is also attractive for those who want freedom from glasses or contact lenses.
8. Can everyone with high myopia get ICL surgery?
   No. Suitability depends on detailed eye measurements such as anterior chamber depth, corneal health, eye pressure, and retinal condition. Two people with similar prescriptions may have different eligibility results.
9. Does corneal thickness affect the choice between ICL and laser surgery?
   Yes. Patients with thinner corneas or higher prescriptions may not be suitable for laser procedures. In such cases, ICL may be considered because it does not involve corneal reshaping.
10. Why is demand for ICL expected to keep increasing in Asia?
    Demand is expected to grow due to rising myopia rates, improved surgical technology, better safety data, and increasing awareness. More patients are also seeking premium, long-term vision correction solutions.

Final Thoughts: Is ICL the Right Choice for You?

The popularity of ICL surgery in Asia is largely driven by the region’s high rates of myopia, growing awareness of refractive surgery, and increasing demand for long-term freedom from glasses and contact lenses. Because ICL can correct higher prescriptions without reshaping the cornea, it has become an important option for many patients who may not be suitable candidates for laser eye surgery.

However, the decision to proceed with ICL should always be based on your individual eye health rather than general trends. If you’re considering ICL surgery in London and want to know if it’s the right option, you’re welcome to reach out to Eye Clinic London to book a consultation.

References:

1. Packer, M. (2018) The Implantable Collamer Lens with a central port: review of the literature. Clinical Ophthalmology, 12, pp. 2427–2438. Available at: https://pubmed.ncbi.nlm.nih.gov/30568421/
2. Montés-Micó, R., Ruiz-Mesa, R., Rodríguez-Prats, J.L. and Tañá-Rivero, P. (2021) Posterior-chamber phakic implantable collamer lenses with a central port: a review. Acta Ophthalmologica, 99(3), e288–e301. Available at: https://pubmed.ncbi.nlm.nih.gov/32841517/
3. Wei, Q., Zhou, X., Chang, W. et al. (2023) Retinal and choroidal changes following implantable collamer lens V4c implantation in high myopia patients: 1-year follow-up study. Diagnostics, 13(19), 3097. Available at: https://www.mdpi.com/2075-4418/13/19/3097
4. Sánchez-González, J.M., Alonso-Aliste, F., Gutiérrez-Ortega, R. and Villa-Collar, C., 2020. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. BMC Ophthalmology, 20, Article 207. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8194243/
5. González-López, F., Mompeán, B., Peixoto-de-Matos, S.C., González-Méijome, J.M. and Villa-Collar, C., 2018. Implantable collamer lens with central hole: 3-year follow-up. Clinical Ophthalmology, 12, pp.2015–2029. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6188208/