Abstract: With the improved safety of implantable collamer lenses (ICL) implantation, a number of studies have been conducted to perform ICL surgery in patients over 40 years of age with high myopia. This article summarizes the advantages, postoperative complications, and remaining problems of ICL implantation for the treatment of high myopia in patients over 40 years of age. The analysis focuses on the choice of correction method, lens power calculation reserve, lens opacity, and decrease in endothelial cell density related to the age of the implanted patient. In contrast to age-appropriate patients, the preoperative selection of correction method and lens power calculation reserve are based on the patient age, patient preference for vision, preoperative refractive power, and adaptability to monocular vision. Lens opacity is the most important complication after ICL implantation in patients over 40 years of age and is one of the reasons for secondary surgery, so a preoperative lens evaluation is recommended. ICL implantation for high myopia over 40 years of age has good treatment results and low complications, but its long-term safety needs further investigation. (Int Rev Ophthalmol, 2023, 47: 233-237)

Key words: implantable collamer lenses, high myopia, over 40-year-old