If you want to reduce your dependence on glasses, there are two broad routes: reshape the cornea with a laser, or place an additional lens inside the eye. Neither is right for everyone, and the honest answer for some people is that glasses or contact lenses remain the better option.
Refractive assessment and surgery at ShivAnuj are carried out by Dr. Anuj Kodnani (MS Ophthalmology, DNB, FTVPEI, FWCRS), who trained in cornea and refractive surgery at Moorfields Eye Hospital, London, the Bascom Palmer Eye Institute, USA, and the London Vision Clinic, and who previously headed refractive services at Parul Vision Laser Center.
ચશ્માં વગરની દ્રષ્ટિ — LASIK અને ICL
LASIK માં લેસરથી કોર્નિયાનો આકાર બદલાય છે, જ્યારે ICL માં આંખની અંદર એક વધારાનો લેન્સ મૂકવામાં આવે છે. કયો વિકલ્પ યોગ્ય છે તે આંખની તપાસ પછી જ નક્કી થાય છે. +91 94289 74800 પર ફોન કરો.
The options side by side
| LASIK / SMILE | ICL | Glasses / contacts | |
|---|---|---|---|
| What it does | Reshapes the cornea with a laser | Adds an implantable lens behind the iris, in front of the natural lens | Corrects light before it enters the eye |
| Removes tissue? | Yes, permanently | No — the lens can be removed | No |
| Suits | Low to moderate numbers with adequate corneal thickness | High myopia, thin corneas, higher astigmatism | Anyone; the default when surgery is not suitable |
| Visual recovery | Often within a day or two | Often within a day or two | Immediate |
| Main trade-offs | Dry eye and night glare, usually temporary; not possible if the cornea is too thin | Intraocular surgery, so a different risk profile; higher cost | Ongoing cost and inconvenience; contact lens infection risk |
The laser family
LASIK creates a thin corneal flap, reshapes the tissue beneath it with an excimer laser, and repositions the flap. Femto-LASIK uses a femtosecond laser rather than a blade to create that flap. Topography-guided LASIK uses a detailed map of your cornea to guide the treatment, which can help with irregular corneas. PRK removes the surface layer instead of making a flap, suiting thinner or irregular corneas but with a slower, more uncomfortable recovery. SMILE removes a small lenticule of tissue through a small incision without a flap. PRESBYOND is a laser blended-vision approach aimed at reducing reading-glasses dependence in the presbyopic age group.
All of these correct the number by changing corneal shape, so all of them depend on having enough healthy corneal tissue to work with. That is why corneal thickness and topography decide candidacy far more than the number itself.
ICL
An Implantable Collamer Lens is a soft lens placed inside the eye, behind the iris and in front of the natural lens, through a small incision. The natural lens is left in place, so the eye retains its own focusing ability where that is still present.
ICL is particularly relevant when:
- The spectacle number is high — beyond what laser can safely correct
- The cornea is too thin or too irregular for laser
- There is significant astigmatism alongside high myopia (a toric ICL can address both)
- Dry eye makes laser surgery less attractive
Because the lens is not fused to the eye, it can be removed or exchanged if circumstances change — a meaningful difference from laser, where tissue removal is permanent.
Who is not a candidate
A thorough workup exists precisely to find the people who should not have surgery. Common reasons to decline or defer include:
- A spectacle number that is still changing — stability for about a year is usually expected
- Insufficient corneal thickness or abnormal topography suggesting keratoconus
- Significant dry eye, active eye infection or inflammation
- Untreated retinal problems, advanced glaucoma or a significant cataract
- Pregnancy or breastfeeding — usually a reason to wait
- Poorly controlled diabetes or certain autoimmune conditions
- For ICL specifically, insufficient space inside the eye or a low endothelial cell count
Being told you are not a candidate is a useful result, not a wasted appointment.
The assessment
Expect a detailed workup rather than a quick check: refraction including a dilated reading, corneal topography and thickness, pupil size, tear film assessment, eye pressure, anterior segment examination and a dilated retinal examination. For ICL, measurements of the internal dimensions of the eye and an endothelial cell count are added. Stop soft contact lenses for several days before the assessment, and rigid lenses for longer, because they temporarily change the corneal shape.
Reading glasses: standard LASIK and ICL do not prevent presbyopia. From the mid-forties, near vision becomes harder because the natural lens stiffens with age, and that happens whether or not you have had refractive surgery. PRESBYOND and certain lens-based options are designed specifically for this age group — they are discussed separately after assessment.
Questions patients ask
Which is better, LASIK or ICL?
Neither is better in the abstract. LASIK suits low to moderate numbers with adequate corneal thickness; ICL suits high numbers, thin corneas and higher astigmatism. The measurements decide, not a preference.
What is the maximum number LASIK can correct?
There is no single figure, because it depends on how much corneal tissue can be safely removed. Thickness and topography matter more than the number alone. When laser is not safe, ICL is often the alternative.
Is the surgery painful?
Anaesthetic drops are used and the procedure itself should not be painful. Grittiness, watering and light sensitivity for a day or so are common afterwards, and PRK is more uncomfortable in the first few days than LASIK.
How soon can I return to work or screens?
Many people return to desk work within two to three days after LASIK or ICL, with screen breaks and lubricating drops. Swimming, dusty environments and contact sports need longer. Your surgeon will give you specific timings.
Can the ICL be removed later?
Yes. The ICL does not remove tissue and can be removed or exchanged by a surgeon if needed — for example if a cataract develops later in life.
Will my number come back?
If the prescription was stable before surgery, a significant return is uncommon, though a small drift can occur. Myopia that is still progressing is the usual reason surgery is postponed until it stabilises.
Is there an age limit?
Surgery is generally not offered before about 18, and only once the prescription has been stable. There is no strict upper limit, but from the fifties onward a developing cataract may make lens-based surgery the more sensible route.
What is PRESBYOND?
PRESBYOND is a laser blended-vision treatment aimed at reducing dependence on reading glasses in the presbyopic age group. Suitability is assessed individually, and it is not right for everyone.
Visit ShivAnuj Eye Hospital & Diagnostic Center
This page is general health information, not a substitute for a clinical examination. Suitability for any procedure is decided only after an in-person assessment. Individual results vary.