ICL for High Myopia in Colombia: The Option When LASIK Says No

Why LASIK stops working at high prescriptions

LASIK corrects vision by removing corneal tissue. Every diopter removed costs roughly 12 to 16 microns of cornea. Above about -8.00 D, the amount of tissue removed either leaves too little residual bed for safety or produces a flattened cornea with poor optical quality, more glare, and a higher regression rate. Most surgeons cap LASIK somewhere between -8 and -10 D, and lower on thin corneas.

The ICL does not touch the cornea at all. It is a soft collamer lens placed between the iris and the natural lens. Because it adds optical power rather than reshaping tissue, it is approved for correction up to -20 D (with astigmatism up to 4 D in the toric model), and it tends to deliver sharper night vision than a high-power ablation.

Who is a candidate

• Myopia between roughly -3 D and -20 D; the strongest case for ICL is -8 D and up
• Age 21 to about 45, with a stable prescription for at least a year
• Anterior chamber depth of at least 2.8 to 3.0 mm, measured at consultation
• Healthy corneal endothelium (cell count typically above 2,000 to 2,300 cells/mm2 depending on age)
• No cataract, glaucoma or uncontrolled uveitis

Anterior chamber depth is the common disqualifier. Highly myopic eyes are usually long and deep, which helps, but not always.

The retina question for high myopes

High myopia stretches the retina. Before any refractive surgery, and independent of which one, a dilated peripheral retinal exam is essential. Lattice degeneration or small tears are treated with laser first, then surgery is scheduled a few weeks later. If a clinic does not dilate you and look at the periphery, that is a warning sign. Read more in our piece on retinal checks for high myopes.

What surgery day looks like

The procedure takes about 10 to 15 minutes per eye. The pupil is dilated, a small 3 mm incision is made at the edge of the cornea, the folded lens is injected and unfolded behind the iris, and the surgeon positions the footplates. The EVO model has a central port, so the older peripheral iridotomy is no longer needed. Many Colombian surgeons do both eyes the same day; some prefer a few days apart for the highest prescriptions.

What to expect afterward

Vision is typically functional within hours and sharp within days. Pressure is checked at day one because retained viscoelastic can spike it briefly. Halos around lights at night are common for a few weeks and usually fade. Long term, you keep annual checks on lens vault, pressure and endothelial cells. See ICL long-term risks for the honest version.

Why Colombia for high-myopia ICL

Colombian ophthalmology has a long track record with ICL because the lens was adopted early in Latin America. The main practical advantage is access: several Medellín and Bogotá surgeons perform ICL weekly, whereas in many US cities the volume is spread across a handful of centers. Verify any surgeon on ReTHUS and ask specifically for ICL case volume, not overall refractive volume.

Frequently asked questions