Visian ICL: Premium Channel for the Extremely Nearsighted

Implications: The Visian ICL (Implantable Collamer Lens) is an exquisitely precise technology for the correction of high degrees of nearsightedness -- much higher than the reach of laser refractive surgery such as LASIK and PRK.  Given the price of the ICL and the intraocular surgey required for its implantation, the out-of-pocket expense for the patient is about US$4000 per eye (about double the average LASIK).  In general, if patients are candidates for LASIK they will have LASIK; it is only those who cannot have LASIK because of their extreme nearsightedness who opt for the ICL.  LASIK works extremely well in the low to moderate nearsightedness range, and it corrects astigmatism as well (there is a toric ICL, but it is not yet approved in the United States). 

Analysis: It is unlikely that the ICL will take significant market share from LASIK because it is twice as expensive and not demonstrably better in the low to moderate range of nearsightedness where either would work well.  However, it does represent an elegant solution for the very nearsighted who, in my experience, are extremely satisfied with the results.  As an addition to a company's refractive portfolio it would represent a clear winner, not as a replacement for LASIK but as an extension of the spectrum of refractive correction.