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EVO ICL: Not just for patients unsuitable for laser vision correction

The EVO ICL procedure is a game-changer, even for low myopia

4 min read
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Mark Wilkins

Mark Wilkins

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Advertorial content is paid for and produced by a sponsor, and is reviewed and edited by the OT team before publication.

01 August 2025

As a refractive surgeon, I see many patients complaining that their contact lenses dry out, shift, and even fall out at times.

Some potential patients are resistant to laser refractive surgery due to fears of permanently altering their eyes. UK consumer research conducted by STAAR Surgical UK & Ireland shows about 48% of contact lens wearers won’t consider laser vision correction, with fears and safety concerns cited as key reasons.1 There is another option, however.

EVO ICL (STAAR Surgical®) is effective for a broad range of refractive errors (-0.50 to -20.00 D), including low, moderate, and high myopia and astigmatism (up to 6.00 D).2-4 The EVO procedure provides outstanding postoperative UCVA,5 stable visual outcomes, and preserves corneal integrity while mitigating the concern of dry eye associated with laser vision correction.6 The U.S. Federal Drug Administration clinical trial three-year data reported zero incidence of pupillary block, angle closure glaucoma or pigment dispersion, with less than 0.2% anterior subcapsular cataract, which is in line with published literature (0% ASC).7

Treating a professional athlete

I recently treated professional footballer Lucy Bronze, who was a great candidate for LASIK. Concern about permanent changes and dry eye was enough for her to seek an alternative to laser vision correction.

Our optometrist refracted her and confirmed a prescription of about -3.00 D in each eye. Her corneas were healthy, her ocular anatomy was suitable for refractive surgery, and we confirmed there was adequate space in the anterior chamber for a phakic lens.

LASIK, while safe and effective, often leads to temporary dry eye symptoms during recovery, and in some cases, patients with pre-existing dryness may experience prolonged discomfort.8,9 EVO ICL, on the other hand, doesn’t disrupt the ocular surface.6 EVO has been clinically shown to not cause or worsen dry eye syndrome.6 For Lucy, this was a major plus, as was the reversibility of ICL.

We discussed the benefits and risks. EVO ICL is an intraocular procedure but it is also reversible, doesn’t affect corneal thickness or stability, and has a high level of postoperative uncorrected distance visual acuity (UDVA), as well as refractive predictability and stability.7,10-12 Additionally, studies suggest phakic IOLs may provide better quality of life scores compared to other refractive procedures, including laser vision correction.13 These were all points Lucy understood and valued.

Lucy’s decision-making was clear and intentional. EVO ICL aligned with her lifestyle, tolerance for risk, and desire for sharp, stable vision, peace of mind of reversibility, without the inducement or worsening of dry eye symptoms.

The procedure took less than 30 minutes. She was quickly seeing 20/20 unaided and was thrilled with the outcome. Collaboration with our optometrist was essential, as it is for all phakic IOL cases.

Lucy was back training and playing competitive sport within a few weeks and has become an advocate of the procedure, sharing her positive experience with the EVO ICL procedure and the impact it’s had on her life and career.

A nice option for low myopia

Although ICL patients have traditionally had higher prescriptions, thinner corneas, or other contraindications to laser vision correction, there is a broader trend toward using the technology to correct lower levels of myopia.2-4 I expect to continue to use it more often, particularly as more people become aware of EVO ICL and the unique benefits it can offer, such as reversibility, not causing dry eye and future flexibility. The ICL procedure doesn’t restrict or complicate future refractive procedures, such as premium lens cataract surgery or clear lens exchange.

“Why I Chose EVO ICL”

By Lucy Bronze, professional footballer, UEFA Women’s EURO Champion 2025 & 2022

“As a professional footballer, my vision really matters. I rely on sharp eyesight to perform my best. I wore contact lenses for years, but over time, I found them becoming more of a hindrance. During practices and games, I started struggling with dryness, irritation, and even lenses falling out. By the end of the day, I couldn’t wait to take my contacts out. I knew it was time for a change.

“I was familiar with laser eye surgery, but had hesitations. The idea of a reversible lens like EVO ICL being implanted inside my eye rather than permanently changing the shape of my cornea with a laser made a lot of sense to me. I liked that it was reversible and wouldn’t cause dry eye problems like contacts or LASIK might.

“Even though I was a candidate for LASIK, Mr Wilkins understood my reasons for preferring EVO ICL and agreed that it was a very good option for me.

“The procedure was quick and painless. I remember being amazed by how clearly I could see, almost immediately. Now, whether I’m training, travelling, or playing in a match, I don’t have to worry about my vision. EVO ICL gave me freedom I hadn’t realised I was missing.”

Important Safety Information for EVO/EVO+ ICL and Visian ICL

The EVO/EVO+ ICL is indicated for phakic patients 21- 60 years of age to correct/reduce myopia up to -20 D with up to 6.0 D of astigmatism and the Visian ICL is indicated for phakic patients 21- 45 years of age to correct/reduce hyperopia up to +16.0 D with up to 6.0 D of astigmatism. Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the DFU. Prior to surgery, physicians should inform prospective patients of possible risks and benefits associated with the EVO/EVO+ ICL or Visian ICL. Reference the EVO/EVO+ ICL and Visian ICL DFUs available online for a complete listing of indications, contraindications, warnings and precautions.

References

  1. Consumer Survey Conducted for STAAR Surgical UK & Ireland by: In-House Research, March 2025.
  2. Kamiya K, Shimizu K, Igarashi A, et al. Posterior chamber phakic intraocular lens implantation: comparative, multicentre study in 351 eyes with low-to-moderate or high myopia. Br J Ophthalmol. 2018;102:177-181.
  3. Kamiya K, Shimizu K, Igarashi A, et al. A nationwide multicenter study on 1-year outcomes of posterior chamber phakic intraocular lens implantation for low myopia. Frontiers in Medicine. 2022;9:762153.
  4. Pinto C, Monteiro T, Franqueira N, Faria-Correia F, Mendes J, Vaz F. Posterior chamber collamer phakic intraocular lens implantation: Comparison of efficacy and safety for low and moderate-to-high myopia. Eur J Ophthalmol. 2022;32(2):894-901.
  5. https://edfu.staar.com/edfu/; eDFU-0001, Rev. 5.
  6. Zhang H, Deng Y, Ma K, Yin H, Tang J. Analysis on the changes of objective indicators of dry eye after implantable collamer lens (ICL) implantation surgery. Graefes Arch Clin Exp Ophthalmol. 2024 Jul;262(7):2321-2328.
  7. Packer M. The Implantable Collamer Lens with a central port: review of the literature. Clin Ophthalmol. 2018;12:2427-2438.
  8. Solomon KD, Holzer MP, Sandoval HP, et al. Refractive Surgery Survey 2001. J Cataract Refract Surg. 2002;28(2):346-355.
  9. Shtein RM. Post-LASIK dry eye. Expert Rev Ophthalmol. 2011;6(5):575-582.
  10. Maloney RK, Geis T. Phakic IOLs an effective option for high myopes. Healio. July 1, 2011. Accessed June 6, 2025.
  11. Liu T, Linghu S, Pan L, Shi R. Effects of V4c-ICL implantation on myopic patients’ vision-related daily activities. J Ophthalmol. 2016;2016:5717932.
  12. Shimizu K, Kamiya K, Igarashi A, Shiratani T. Intraindividual comparison of visual performance after posterior chamber phakic intraocular lens with and without a central hole implantation for moderate to high myopia. Am J Ophthalmol. 2012;154(3):486-494.e1
  13. Ieong A, Hau SC, Rubin GS, Allan BD. Quality of life in high myopia before and after implantable Collamer lens implantation. Ophthalmology. 2010 Dec;117(12):2295-300.
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