High myopia
Not sure you are a candidate for laser surgery? Take the online eligibility test — if it points you toward an alternative, the phakic ICL implant is often the best one.
Phakic implant (ICL/IPCL): high myopia in Paris and Cachan
The phakic implant is the gold-standard solution for high myopia (-8 to -20 D) when laser surgery is not an option. A reversible procedure with excellent results.
UNDERSTANDING THE PHAKIC IMPLANT
What is a phakic implant? Principle and how it works
The phakic implant is a biocompatible intraocular lens placed inside the eye, in front of the natural lens (which is preserved, hence the term “phakic”). Unlike LASIK or PRK, which reshape the cornea, the phakic implant corrects the refractive error by adding a corrective lens inside the eye, like a “permanent internal contact lens”.
The two most widely used models are the ICL (Implantable Collamer Lens) from STAAR Surgical and the IPCL (Implantable Phakic Contact Lens) from Care Group. These implants are made of Collamer or a hydrophilic acrylic material, biocompatible and fitted with a UV filter. Their main advantage: they are fully reversible. If needed, the implant can be removed or exchanged without any irreversible consequence for the eye.
The phakic implant is the gold-standard solution for high myopia (from -8 to -20 dioptres, or even beyond) and high hyperopia (up to +10 D), when laser surgery is contraindicated because of a cornea that is too thin or a correction that is too high. More than 2 million ICL implants have been placed worldwide with a 99% satisfaction rate (STAAR Surgical data, 2024).
INDICATIONS
Who is a candidate for a phakic implant?
- High myopia (-8 to -20 D) not eligible for laser surgery because of a cornea that is too thin or a correction that is too high
- High hyperopia (up to +10 D)
- Associated astigmatism (toric models correct up to 6 D of astigmatism)
- Cornea too thin for LASIK or PRK
- Age: 21 to 45 years (beyond this, the natural lens loses its accommodation and cataract surgery with a monofocal or multifocal implant is often preferable)
- Anterior chamber deep enough (> 2.8 mm for posterior chamber ICLs): measured during the pre-operative work-up
- Normal endothelial cell density (> 2,500 cells/mm²)
HOW THE PROCEDURE WORKS
How a phakic implant is placed
Placing a phakic implant (ICL), step by step
A soft lens slipped behind the iris, in front of the preserved natural lens.
-
1
Injection through a micro-incision
The soft, folded implant is introduced into the eye through a 2.5 to 3 mm micro-incision using an injector. The natural lens is preserved.
-
2
Unfolding of the implant
Once inside, the implant unfolds gradually and gently within the anterior segment of the eye, before being positioned behind the iris and in front of the natural crystalline lens.
-
3
Positioning behind the iris
The tips (haptics) are slipped behind the iris. The implant thus sits between the iris and the natural lens, without touching it.
-
4
Result: the vault
The implant remains slightly vaulted above the natural lens (a safety gap). Discreet and reversible, it corrects high myopia.
- Comprehensive pre-operative work-up: Topography, biometry, endothelial cell count, anterior chamber measurement. Custom implant order (personalised size and power). Manufacturing time: 2 to 4 weeks.
- Topical anaesthesia: Anaesthetic eye drops and pupil dilation. Outpatient procedure.
- Micro-incision (2.2 to 2.8 mm): The surgeon makes a self-sealing corneal incision, without sutures.
- Injection of the implant (1 minute): The implant, folded in an injector, is introduced into the anterior chamber then deployed behind the iris, in front of the natural lens. It unfolds automatically and settles in the ciliary sulcus (ICL) or in front of the iris (iris-fixated models).
- Intra-operative check: Verification of implant centering, of the space between the implant and the natural lens (vault) and of the intraocular pressure.
- Total duration: 15 to 20 minutes per eye. Both eyes are generally operated on one week apart.
CLINICAL RESULTS
What results after a phakic implant?
- Day 1: Vision markedly improved. Mandatory check-up: verification of the vault, pressure and centering. Most patients see 8/10 to 10/10 as early as the next day.
- Week 1: Normal resumption of activities. Anti-inflammatory eye drops for 3 to 4 weeks.
- Month 1: Stabilised result. 98% of patients reach 10/10 or better for myopia of -8 to -15 D.
- Annual follow-up: Monitoring of intraocular pressure, endothelial cell count and natural lens transparency. This lifelong follow-up is recommended.
Decisive advantage of the phakic implant: the quality of vision is often superior to that obtained with laser surgery for high corrections. The implant does not alter the corneal surface, so the optical aberrations it induces are minimal. Patients describe vision that is “sharper” and “more contrasted” than with their glasses or contact lenses.
Passaro 2026 (meta-analysis, 214 studies)
Kamilov 2025 (ICL V5, high myopia)
beyond the limits of LASIK
SURGICAL EXPERTISE
Why choose Dr Tourabaly for your phakic implant
The phakic implant (ICL EVO Visian) is a precision surgery, particularly indicated when LASIK is not suitable (high myopia beyond -10 D, thin cornea, dry eye). The choice of surgeon and of the technical platform are decisive.
Academic background
Former Chef de Clinique at the Quinze-Vingts National Ophthalmology Hospital (Paris), Sorbonne University. Specialised in refractive surgery and the anterior segment.
Indication tailored to your eye
The ICL EVO is offered when it is the most suitable solution: high myopia (beyond -10 D), thin cornea, dry eye, or patient preference. The decision is based on the pre-operative work-up, never by default.
Reference-grade technical platform
Comprehensive pre-operative work-up at the Cachan practice: Sirius (CSO), IOL Master 700 (Zeiss) for ACD/axial length biometry, endothelial cell count (ECD), anterior segment OCT. Surgery at the Clinique Sainte-Geneviève (Paris 14th).
Follow-up and reassurance
Post-operative follow-up over the first 4 weeks (Day 1, Day 7, Day 30) at the Cachan practice. More than 1,100 Google reviews · 4.9/5. See patient testimonials.
CHOOSING THE TECHNIQUE
Phakic implant vs LASIK: which to choose?
It is not a matter of “one or the other” but depends on your eye anatomy:
- Myopia < -8 D + thick cornea → LASIK or SMILE (laser correction, fast recovery)
- Myopia -8 to -20 D, or cornea too thin → Phakic implant (optimal quality of vision, reversible)
- Myopia < -6 D + thin cornea → PRK (surface laser, no flap)
The pre-operative work-up is the key step in determining the optimal technique. Dr Tourabaly will always recommend the safest and most effective solution for your case. See also our refractive surgery page.
Where are the procedures performed?
Phakic implant surgeries are performed at:
• Clinique Sainte-Geneviève (Paris 14), operating theatre dedicated to ophthalmology
The pre-operative work-up (Sirius CSO, IOL Master 700) is carried out at the Cachan practice (94). Post-operative follow-up can take place in Cachan or in Paris 13th.
Our practices
Phakic implant consultation with Dr Tourabaly
Pre-operative work-up: Cachan practice (94)
1 Ter Rue Camille Desmoulins, 94230 Cachan
Tel: +33 1 45 47 08 11 · Monday-Friday 9am-6pm
Sirius CSO biometry + IOL Master 700 + endothelial cell count.
Surgery: Clinique Sainte-Geneviève (Paris 14th)
Clinique Sainte-Geneviève, Paris 14
Outpatient · operating theatre dedicated to ophthalmology
Post-operative follow-up (Day 1, Day 7, Day 15, Day 30) at the Cachan practice.
Frequently asked questions
PATIENT TESTIMONIALS
Google reviews on the phakic implant and the other techniques
Have you been operated on by Dr Tourabaly? Your feedback helps other patients make their decision with confidence.
In the meantime, browse the practice’s more than 1,100 Google reviews · 4.9/5 covering all the techniques performed: see all testimonials →
FAQ
Frequently asked questions about the phakic implant
This article is for information purposes only. A personalised ophthalmological opinion remains essential for any treatment decision.
Phakic implant: key long-term figures
Indicative figures from prospective and retrospective studies published in the international ophthalmology literature. Results depend on the individual anatomical profile (ACD, white-to-white diameter, endothelium).
The 3 types of phakic implant used today
ICL / EVO Visian
- Placed behind the iris, in front of the natural lens
- Biocompatible Collamer material (porcine collagen)
- Myopia correction up to −18 D
- EVO version: CentraFLOW™ central hole, no more iridotomy
- Toric version (EVO+ Toric) for astigmatism
IPCL (Care Group)
- Indian alternative to the ICL, hydrophilic
- Extended correction range (myopia, hyperopia)
- Available in toric and presbyopic versions
- Lower cost than the ICL EVO
- More recent scientific data (2016+)
Artisan / Artiflex
- Fixed to the iris (enclavated)
- Indications: high hyperopia, very deep anterior chambers
- More limited use today (the ICL is preferred)
- Enhanced endothelial monitoring required
- Artiflex: soft injectable version
ICL phakic implant vs LASIK vs daily contact lenses
| Criterion | Phakic implant (ICL/EVO) | LASIK | Contact lenses |
|---|---|---|---|
| Myopia range | Up to −18 D | Up to −8 to −10 D | All |
| Corneal thickness | Not a limiting factor | ≥ 490 μm required | Not a limiting factor |
| Reversibility | Yes (implant removable) | No | Yes |
| Lifespan | For life (removal possible) | For life | 1 day to 1 month |
| Dry eye | No direct impact | Transient 3–6 months | Worsened |
| Annual infection risk | < 0.1% | < 0.1% | 0.3 – 4% (prolonged wear) |
| Cost over 30 years | from €4,700 | ≈ €2,400 total | ≈ €15,000 cumulative |
In summary: the phakic implant is the right choice when the cornea does not allow LASIK (too thin, too curved, suspicious topography) or when myopia exceeds −10 D. It remains the only reversible surgical technique within refractive surgery.
How much does a phakic implant cost?
The price of an ICL EVO phakic implant is set by written quote, once the pre-operative work-up is complete. It comprises the surgeon’s fees (€1,200 per eye), the Clinique Sainte-Geneviève package (€650 + €48 day-surgery fee, for both eyes), the ICL implant itself (€790 to €1,250 per eye depending on its power and on the toric EVO Toric version, which corrects both myopia and astigmatism) and the anaesthetist’s fees (by quote).
The phakic implant is not reimbursed by the French national health insurance when correcting a refractive error. Premium private health insurers cover part of the procedure (allowance of €200–800 per eye depending on the policy). Important: in certain indications (myopia > −16 D considered pathological), partial coverage may be discussed with your insurance fund.
These prices are indicative and will be confirmed at the pre-operative consultation, after biometric measurements (ACD, WTW, ECD, topography) and calculation of the personalised implant power.
Scientific sources (PubMed)
- Kim YH, Yoon CH, Kim MK. Long-term Outcome and Related Risk Factors in Implantable Collamer Lens Implantation of High Myopia. Korean J Ophthalmol 2025;39(2):134-144. DOI: 10.3341/kjo.2024.0094
- Li B, Chen X, Zhu R, et al. Long-Term Clinical Outcomes of Posterior Chamber Phakic Refractive Lens Implantation for Correction of Super-High Myopia. Curr Eye Res 2025;51(1):40-45. DOI: 10.1080/02713683.2025.2549293
- Zhang H, Han Y, Yang Y, et al. Evaluation of Short-Term Safety and Efficacy of Myopia Correction with a Novel Posterior Chamber Phakic Intraocular Lens. Ophthalmol Ther 2025;15(1):361-371. DOI: 10.1007/s40123-025-01278-w
References selected via PubMed (US National Library of Medicine).
Your cornea does not allow LASIK? The phakic implant is often a suitable alternative.
Book an appointment with Dr Tourabaly for a feasibility work-up. Complete biometry + ECD + topography to determine whether you are eligible for the ICL EVO.