At present, Implantable Collamer Lens (ICL) implantation has become the most commonly selected refractive procedure in Japan for the correction of myopia and astigmatism, accounting for approximately 70% of refractive surgeries.
1. Japan Has a High Prevalence of High Myopia
Japan has one of the world’s highest prevalences of myopia and high myopia.
ICL implantation can effectively correct a wide range of refractive errors, from mild to very high myopia (approximately −0.75 to −16.00 diopters).
Many of these patients are not ideal candidates for LASIK or SMILE Pro because they have:
- High myopia
- Thin corneas
- Concerns regarding long-term visual quality
As a result, ICL implantation has naturally become an important refractive option for this patient population.
2. Japanese Patients Tend to Prioritize Long-Term Safety Over Procedural Convenience
Japanese patients generally place a high value on:
- Preserving the natural ocular anatomy
- Technologies supported by robust long-term clinical evidence
- Lower procedural risk, even if the treatment pathway involves more comprehensive evaluation
ICL implantation aligns well with these preferences because it:
- Preserves the native corneal structure
- Can be removed or exchanged if clinically indicated
- Is supported by more than 20–30 years of long-term clinical data
3. ICL Is Regarded as a Premium Refractive Solution in Japan
In Japan, ICL is not viewed merely as an alternative for patients who are unsuitable for LASIK. Instead, it is considered a primary refractive correction option across a broad spectrum of myopia, particularly for individuals seeking superior visual quality.
Common candidates include:
- Professionals performing visually demanding work, such as those in information technology, engineering, and design
- Individuals with extensive daily visual demands
- Patients wishing to minimize the risk of postoperative dry eye
- Those seeking exceptional intermediate- and distance-vision quality
- Individuals who frequently rely on high-quality vision under low-light or nighttime conditions
4. Japan Has Highly Specialized ICL Centers
- Many ophthalmic centers specialize primarily in ICL implantation.
- Preoperative assessment and patient selection are highly comprehensive.
- Japanese ophthalmic surgeons have extensive clinical experience and have treated a large number of patients.
- Patients generally accept a more detailed preoperative evaluation, recognizing the importance of thorough screening before surgery.
5. ICL Adoption Continues to Increase in Japan
- The proportion of patients selecting ICL has increased steadily each year, reaching approximately 70% by 2025.
- The procedure is particularly popular among individuals aged 20–40 years.
- This trend is consistent with that observed in several other developed countries.
ICL has become increasingly popular not because LASIK is an inferior procedure, but because patients now have more refractive options available and are better able to choose the treatment that best matches their ocular characteristics, visual requirements, and long-term expectations.