High myopia

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.

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01 45 47 08 11

Written and medically reviewed by Dr Moïse Tourabaly · Last updated: July 6, 2026

UNDERSTANDING THE PHAKIC IMPLANT

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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.

cornea natural lens iris phakic implant vault NATURAL LENS PRESERVED · REVERSIBLE IMPLANT
  1. 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. 2

    Unfolding of the implant

    Once inside, the implant unfolds gradually and gently within the anterior chamber of the eye.

  3. 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. 4

    Result: the vault

    The implant remains slightly vaulted above the natural lens (a safety gap). Discreet and reversible, it corrects high myopia.

  1. 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.
  2. Topical anaesthesia: Anaesthetic eye drops and pupil dilation. Outpatient procedure.
  3. Micro-incision (2.2 to 2.8 mm): The surgeon makes a self-sealing corneal incision, without sutures.
  4. 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).
  5. Intra-operative check: Verification of implant centering, of the space between the implant and the natural lens (vault) and of the intraocular pressure.
  6. Total duration: 15 to 20 minutes per eye. Both eyes are generally operated on one week apart.

CLINICAL RESULTS

Recovery and results

  • 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.

Book an appointment · Phakic implant work-up
+45 000 eyes
Clinical validation
Passaro 2026 (meta-analysis, 214 studies)
89 %
Accuracy within ±0.50 D
Kamilov 2025 (ICL V5, high myopia)
-18 D
Max myopia corrected
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 Chief Resident 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 1,000 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 exclusively 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: 01 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.

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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 1,000 Google reviews · 4.9/5 covering all the techniques performed: see all testimonials →

FAQ

Frequently asked questions about the phakic implant

The ICL EVO Visian is indicated for myopia from -3 to -18 dioptres, with or without associated astigmatism (up to -6 D with the toric version). It is particularly suited to high myopia (beyond -8 D), where laser surgery reaches the limits of corneal safety. It can also be offered to younger patients (from age 21) with a thin cornea, severe dry eye, or who play contact sports.

Yes, unlike corneal laser surgeries (LASIK, PRK, SMILE). The phakic implant is placed between the iris and the natural lens, without altering the tissues. It can be removed or replaced if needed, in particular during future cataract surgery. This reversibility makes it a reassuring option for patients wishing to preserve their corneal capital.

Like any intraocular procedure, ICL implantation carries risks to be aware of: transient post-operative inflammation, raised eye pressure, early cataract (0.5 to 2% depending on the series at 10 years), rare decentration requiring repositioning, and very exceptionally endophthalmitis (1/3000 to 1/5000). A rigorous pre-operative work-up (biometry, ECD, topography, anterior chamber depth) significantly reduces these risks.

LASIK reshapes the cornea with a laser (corneal surgery), whereas the ICL adds an intraocular lens between the iris and the natural lens (intraocular surgery). LASIK is reserved for low to moderate myopia, with a thick cornea. The ICL is suitable for high myopia, thin corneas or borderline forms of keratoconus. The ICL is reversible, LASIK is not. Visual outcomes are comparable in the long term, often above 95% satisfaction.

For the ICL EVO Visian at Dr Tourabaly’s practice, the surgeon’s fee is €1,200/eye (€2,400 for both eyes), the Clinique Sainte-Geneviève fee is €650 + €48 day-surgery fee (for both eyes), plus the ICL implant, billed separately on quotation depending on its power and on the toric version, and the anaesthetist’s fees (on quotation). This package includes the procedure, topical anaesthesia, post-operative follow-up over the first 4 weeks (Day 1, Day 7, Day 15, Day 30) and any retouch during the first 6 months.

The total cost per eye (implant included) is in practice around €2,800/eye for a standard ICL EVO and €3,200/eye for the toric version. A written quotation compliant with Article 53 of the French Medical Code of Ethics is always provided. See the full price list. Like all refractive surgeries, the ICL is not reimbursed by the French national health insurance; private health insurance may cover part of it depending on the policy.

No. Refractive surgery (LASIK, PRK, SMILE, ICL) is considered elective surgery by the French national health insurance and is therefore not reimbursed. However, most private health insurers offer a “refractive surgery” allowance ranging from €200 to €800 per eye, or even more on certain premium policies. A detailed quotation is provided at the end of the pre-operative work-up for submission to your private insurer.

The procedure takes about 15 to 20 minutes per eye, as an outpatient, under topical anaesthesia with eye drops. Both eyes are usually operated on a few days apart to make recovery safer. Vision recovery is regained as early as the next day, with a return to work possible within 48-72 hours. Antibiotic and anti-inflammatory eye drops are prescribed for 3 to 4 weeks.

This article is for information purposes only. A personalised ophthalmological opinion remains essential for any treatment decision.

Phakic implant: key long-term figures

98.5%
of patients retain an endothelial cell density > 2000 cells/mm² at 10 years
−22 D
correction range for high myopia (up to −18 D, cyl. −6 D)
12+ years
of scientific data available on posterior chamber ICLs
100%
reversible: removal possible without corneal alteration

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

Posterior chamber

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
Posterior chamber

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+)
Anterior chamber

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

Dr Moïse Tourabaly · Chirurgie réfractive

Quelle technique agit où dans l'œil ?

Coupe du segment antérieur de l'œil et zone traitée par chaque technique de chirurgie réfractive. Coupe vue de profil, avant de l'œil à gauche : cornée avec épithélium et stroma, chambre antérieure, iris, chambre postérieure et cristallin conservé. La PKR agit à la surface de la cornée, le LASIK dans le stroma sous un capot, le SMILE retire un lenticule intrastromal, l'ICL place un implant en chambre postérieure derrière l'iris sans toucher la cornée. Le trajet de la lumière traverse la pupille jusqu'au fond de l'œil. lumière Cornée Iris Cristallin stroma chambre antérieure chambre postérieure pupille Surface traitée Capot + stroma Lenticule retiré Implant, derrière l'iris cornée non touchée
Technique cornéenne · on remodèle la cornée Implant intraoculaire · la cornée n'est pas touchée

PKR : le laser agit à la surface de la cornée, après retrait de l'épithélium. Souvent proposée pour les cornées fines ou les myopies faibles à modérées.

LASIK : un fin capot cornéen est découpé, le laser traite le stroma en dessous, puis le capot est repositionné. Possible pour la myopie, l'hypermétropie et l'astigmatisme si l'épaisseur de la cornée le permet.

SMILE : un lenticule est retiré dans l'épaisseur du stroma par une petite incision. Préserve davantage la structure de la cornée.

ICL : un implant est placé derrière l'iris, devant le cristallin conservé, sans toucher la cornée. Souvent proposé pour les fortes myopies ou les cornées trop fines pour le laser.

Zone traitée par la technique choisie Trajet de la lumière Structures naturelles conservées

Schéma indicatif. Le choix d'une technique se décide après un bilan préopératoire complet ; les résultats varient selon les patients.

CriterionPhakic implant (ICL/EVO)LASIKContact lenses
Myopia rangeUp to −18 DUp to −8 to −10 DAll
Corneal thicknessNot a limiting factor≥ 490 μm requiredNot a limiting factor
ReversibilityYes (implant removable)NoYes
LifespanFor life (removal possible)For life1 day to 1 month
Dry eyeNo direct impactTransient 3–6 monthsWorsened
Annual infection risk< 0.1%< 0.1%0.3 – 4% (prolonged wear)
Cost over 30 years≈ €5,600 total≈ €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.

Pricing and coverage of the phakic implant

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.

All-inclusive package
€2,800
per eye · standard ICL EVO (package + implant): includes the pre-operative work-up, the procedure, the implant, post-operative follow-up over the first 4 weeks included (Day 1, Day 7, Day 15, Day 30) and retouch during the first 6 months included.
Toric version
€3,200
per eye · EVO Toric: for simultaneous correction of myopia + astigmatism. Supplement linked to the cost of the custom implant ordered on a personalised biometric quotation.
Financing
0%
Possibility of payment in 3 or 4 instalments by cheque. Precise quotation provided at the consultation with full biometry calculation.

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)

  1. 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
  2. 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
  3. 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.

Book an appointment on Doctolib Discover the pre-operative work-up
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Understand it visually

The ICL implant: a lens inside the eye

When laser surgery is not indicated (high myopia, thin cornea), the ICL EVO implant sits discreetly behind the iris, without touching the cornea.

Related topics

Written and medically reviewed by Dr Moïse Tourabaly, ophthalmologist — former chief resident (Quinze-Vingts National Eye Hospital). Last updated: July 6, 2026

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