Advances in personalized surgical strategies for ICL implantation: Effects of implantation pathways on lens stability and visual quality

Abstract

Implantation of a phakic posterior chamber intraocular lens (implantable collamer lens [ICL]) is a common surgical technique for correcting myopia and myopic astigmatism. The postoperative success of a toric phakic posterior chamber intraocular lens (toric ICL) depends mainly on its rotational stability. However, traditional standardized implantation methods often fail to achieve precise correction, primarily because they do not sufficiently account for individual variations in ocular anatomy. This review examines recent advances in personalized ICL surgery, focusing on how implantation pathways affect lens stability and visual quality. It examines key influencing factors, relevant evaluation systems, and the clinical effectiveness of personalized incisions and vertical implantation techniques. It also highlights the benefits of customized strategies in terms of refractive correction accuracy, vision quality, and patient satisfaction. Finally, it discusses current challenges, such as limited evidence-based support, and explores future directions, including artificial intelligence–assisted surgical decision-making. Ultimately, this review aims to provide a theoretical foundation for optimizing clinical protocols for ICL implantation.