“Is ICL the same as cataract surgery, in that both involve inserting a lens inside the eye?”
“If I undergo ICL, what happens if I develop cataracts in the future?”
“What exactly is the difference between ICL and cataract surgery?”
Some of patients who are considering ICL may have questions like these.
ICL and cataract surgery both involve inserting a small lens into the eye, but their purposes and what is done during surgery are very different.
Today, We will explain the differences between ICL and cataract surgery in an easy-to-understand way.

【First, What Is the “Crystalline Lens”?】
To understand the difference between ICL and cataract surgery, you first need to know about the “crystalline lens.”
The crystalline lens is a transparent, lens-like tissue inside the eye.
Like a camera lens, it refracts light entering the eye and focuses it onto the retina.
The crystalline lens also adjusts focus by changing its thickness, such as when looking at something up close.
However, as we age, the crystalline lens can become cloudy.
This is called a cataract.
Cataracts can cause symptoms such as decreased vision, blurry vision, and glare.

【The Biggest Difference Between ICL and Cataract Surgery】
The biggest difference between ICL and cataract surgery is whether the crystalline lens is kept or removed.
<In the Case of ICL>
With ICL, a small lens is inserted into the eye while keeping the crystalline lens in place.
ICL is called a “phakic intraocular lens,” and it is generally placed behind the iris and in front of the crystalline lens.
In other words, the state becomes:
Crystalline lens + ICL

<In the Case of Cataract Surgery>
In cataract surgery, the cloudy crystalline lens is removed, and an intraocular lens is inserted into the eye to replace it.
In other words, it is a treatment that:
Removes the crystalline lens → Replaces it with an intraocular lens
This difference is the most important point in understanding ICL and cataract surgery.

【What Is ICL For?】
ICL is primarily a treatment for correcting refractive errors such as myopia, hyperopia, and astigmatism.
It is considered as one option by people who want to live without glasses or contact lenses.
With ICL, instead of cutting the cornea, a lens is inserted into the eye to adjust refraction.
In the guidelines for refractive surgery by the Japanese Ophthalmological Society, phakic intraocular lenses such as ICL are indicated for moderate to high myopia, hyperopia, astigmatism, etc.

【What Is Cataract Surgery For?】
Cataract surgery is a surgery aimed at improving the decline in visual function caused by cataracts by removing the cloudy crystalline lens and replacing it with an intraocular lens.
Cataracts are often caused by aging, and it is said that about 70% of people in their 60s, about 90% in their 70s, and almost everyone in their 80s have them.
When cataracts progress and make it difficult to see, surgery becomes the main treatment.

【Comparing ICL and Cataract Surgery】

	ICL	Cataract Surgery
Main Purpose	Correction of myopia, hyperopia, astigmatism, etc.	Improvement of visual function decline due to cataracts
Crystalline Lens	Kept	Removed
Lens Used	ICL (phakic intraocular lens)）	Intraocular lens
Position of Lens	In front of the crystalline lens	In the position after the crystalline lens is removed
Main Candidates	People with refractive errors	People whose vision has become poor due to cataracts

	ICL	Cataract Surgery
Main Purpose	Correction of myopia, hyperopia, astigmatism, etc.	Improvement of visual function decline due to cataracts
Crystalline Lens	Kept	Removed
Lens Used	ICL (phakic intraocular lens)）	Intraocular lens
Position of Lens	In front of the crystalline lens	In the position after the crystalline lens is removed
Main Candidates	People with refractive errors	People whose vision has become poor due to cataracts

*Actual indications and surgical methods vary depending on the condition of the eye.

【If I Have ICL, What Happens If I Develop Cataracts in the Future?】
This is one of the questions frequently asked by people considering ICL.
Because ICL is inserted while keeping the crystalline lens, there is a possibility that the crystalline lens may become cloudy due to aging in the future, leading to cataracts.
ICL itself does not treat cataracts.
Therefore, if cataracts progress in the future and surgery becomes necessary, after checking the condition of the eye, removal of the ICL and cataract surgery will be considered.
In addition, although extremely rare, complications such as cataracts can occur with ICL surgery.
When undergoing surgery, it is important to receive a sufficient explanation from the doctor about such risks.

【Will I Still Get “Presbyopia” Even with ICL?】
This is also an important point for those considering ICL.
ICL is a treatment for correcting refractive errors such as myopia, hyperopia, and astigmatism, and it is not a treatment that stops the changes in the crystalline lens caused by aging.
The ability of the crystalline lens to adjust focus decreases with age.
Therefore, even if ICL makes it easier to see distant objects, “presbyopia”—difficulty seeing near objects—can occur with age.
Especially for those considering ICL in their 40s or later, it is important to discuss not only current myopia, hyperopia, and astigmatism but also future vision with the doctor.

【Which Treatment Is Suitable for My Eyes?】
ICL and cataract surgery are treatments with fundamentally different purposes.
ICL is primarily a treatment for correcting refractive errors,
and cataract surgery is a treatment for improving the decline in visual function caused by cataracts by removing the cloudy crystalline lens and replacing it with an intraocular lens.
Therefore,
rather than asking “Should I choose ICL or cataract surgery?”
it is important to think from the perspective of “Which treatment is suitable for my current eye condition?”

【When Considering ICL, Think Not Only About the Present but Also About Future Changes in Your Eyes】
ICL is a treatment that corrects vision while keeping your own crystalline lens.
On the other hand, keeping the crystalline lens also means that age-related changes to the crystalline lens may occur in the future.
Especially for those in their 40s and 50s considering ICL,

• ・Current state of myopia, hyperopia, and astigmatism
• ・Condition of the crystalline lens
• ・Degree of presbyopia
• ・Future vision
• ・Benefits and risks of ICL surgery

It is important to consider these comprehensively.
Whether ICL is suitable is not determined by age alone.
After a detailed examination of your eye condition, consult sufficiently with your doctor and consider the treatment.

【Summary】
ICL and cataract surgery are both treatments that use intraocular lenses, but their purposes and methods are very different.
ICL

• ・Primarily a treatment for correcting myopia, hyperopia, astigmatism, etc.
• ・Keeps your own crystalline lens
• ・Inserts a lens in front of the crystalline lens

Cataract Surgery

• ・A treatment for improving the decline in visual function caused by cataracts
• ・Removes the cloudy crystalline lens
• ・Inserts an intraocular lens in place of the crystalline lens

When considering ICL, it is important to understand not only whether you currently need glasses or contact lenses but also age-related changes in your eyes, such as future presbyopia and cataracts.
The suitable treatment differs depending on your eye condition and lifestyle.
First, start by having an eye examination and learning about your own eye condition.