Refractive surgical procedures, whether corneal or lenticular, are numerous. They provide a logical extension to the more orthodox (non-surgical) conventional management of refractive errors. Patient selection criteria, technique and complications for each procedure are varied. Every technique has its limitations and every patient deserves the optimal approach in choosing the most suitable approach to manage his error according to the optical principles behind his error and his clinical examination. Implantable Contact Lens (ICL) is a new member of the posterior chamber phakic intraocular lenses (PC-PIOLs). Its newly devised material (collamer), has thoroughly and repeatedly undergone tests for compatibility. The lens geometric and optical design has been remodeled in attempts to avoid complications related to earlier models. Several experienced surgeons’ have expressed their views of the surgical technique of implanting the ICL, indications, contraindications, investigations, patient selection and preparation for surgery, and complications. After several trials an advanced stage of testing has been reached. Comparing ICL to LASIK (as a corneal refractive surgical) and Baikoff Lens implantation (as an AC-PIOL 'lenticular' procedure) showed that all techniques have their advantages and disadvantages. ICL is a new technique that while having its advantages and disadvantages, is considered a useful addition to the refractive surgical armamentarium. Full analysis of the causes behind observed complications (e.g.: cataract) is mandatory done to assess its safety and reliability.