Frequently Asked Questions

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EVO is a refractive lens also known as a phakic IOL. “Phakic” meaning that the natural lens of the eye is in place, and “IOL” meaning intraocular lens, or a lens inside the eye. The EVO is a posterior chamber implant that is situated through a small incision in the eye behind the iris (the coloured part of the eye), and in front of the natural crystalline lens in order to improve your near-sightedness, farsightedness or astigmatism.

EVO Visian ICL surgery is intended to safely and effectively correct near-sightedness (-0.5 to -18.0 dioptres (D)), the reduction of near-sightedness in patients with up to -20 dioptres (D) of near-sightedness, treatment of astigmatism from +0.5D to +6D and and correction of farsightedness from 0.5 to 10.0D. It is indicated for patients who are at least 21 years of age.

In order to be sure that your surgeon will use an EVO Visian ICL lens with the most adequate power for your eye, your near-sightedness should be stable for at least a year before undergoing eye surgery.

The EVO Visian ICL represents an alternative to other refractive surgeries including laser assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), other laser vision correction procedures, incisional surgeries or other means to correct myopia such as contact lenses and eye glasses.

Patients who are pregnant and nursing and patients with a narrow angle in the front chamber of their eye, because in this case the space for the EVO lens would be too small. The patient education booklet provides an additional list of conditions that should be taken into consideration when making a decision about the EVO procedure.

The key benefit of EVO surgery is the permanent correction or reduction of your near-sightedness, farsightedness or astigmatism allowing you to see clearly without eyeglasses or contact lenses or reduce your dependence upon them. In addition to the improvement of your uncorrected vision (vision without eyeglasses or contact lenses), your best corrected vision (best vision with contact lenses/eye glasses) may be improved.

The material is called Collamer® , a collagen co-polymer that contains a small amount of purified collagen which is proprietary to STAAR Surgical; the remainder is made of a similar material to that found in soft contact lenses. It is very biocompatible (does not cause a reaction inside the eye) and stable. It also contains an ultraviolet light filter.

EVO is intended to remain in place without maintenance. The lens can be removed by your eye care professional if needed in the future. If your physician removes the lens, you will lose the benefit of your vision correction.

Prior to being placed on the market, EVO was subject to extensive research and development. Today, more than 1,000,000 lenses in the EVO family have been implanted worldwide. In a US clinical study, over 99,4 percent of patients were satisfied with their implant. The EVO has a track record of excellent clinical outcomes. Additionally, the lens has been available internationally for over 15 years.

No. EVO is positioned behind the iris (the coloured part of the eye), where it is invisible to both you and others. Only your eye care practitioner will be able to tell that vision correction has taken place.

EVO is not typically noticeable after it is implanted. It does not attach to any structures within the eye and does not move around once in place.

If you are a potential candidate who is interested in obtaining further EVO Visian ICL information, you should contact a qualified EVO Visian ICL surgeon. Physicians should contact STAAR Surgical Company, the maker of the EVO Visian ICL, to learn more.

The EVO surgery is performed on an outpatient basis which means that the patient has surgery and leaves the same day. The procedure itself usually takes 20-30 minutes or less. The patient will need someone to drive them home on surgery day. A light, topical or local anaesthetic is administered. There is very little discomfort during or after surgery. Some eye drops or medication may be prescribed and a visit with your eye care professional is usually scheduled the day after surgery.

Early complications reported the first week after EVO surgery include: EVO removal and reinsertion at the time of initial surgery, shallowness of the front chamber of the eye that can create an increase of the pressure into your eye and may necessitate a peripheral iridectomy (a procedure where a small hole is placed in iris (colored part of eye) using a laser called “YAG laser), temporary corneal swelling (edema) and transient inflammation in the eye or iritis. Complications after 1 week include: increase in astigmatism, loss of best corrected vision, clouding of the Crystalline lens (cataract), loss of cells from the back surface of the cornea responsible for the cornea remaining clear (endothelial cell loss), increase in eye pressure, iris prolapse, cloudy areas on the crystalline lens that may or may not cause visual symptoms (crystalline lens opacities), macular hemorrhage, subretinal hemorrhage, retinal detachment, secondary EVO related surgeries (replacements, repositionings, removals, removals with cataract extraction), too much or too little nearsightedness correction, and additional YAG iridotomy necessary.

Potential complications for refractive surgery in general include: irritation of the conjunctiva (white part of eye), corneal swelling (outer layer of eye), eye infection, significant glare and/or halos around lights, blood/pus in the eye, lens dislocation, macular edema, (swelling in back of the eye), non-reactive pupil, pupillary block glaucoma resulting in raised eye pressure, irritation of the iris (colored part of the eye), severe inflammation of the eye and loss of the vitreous (gel in back of eye). You should carefully review all benefits and risks of EVO ICL surgery with your eye care professional before making a decision about the EVO ICL.

Follow all of your eye care professional’s instructions before and after implantation of the EVO lens. Take any prescribed medication and schedule all recommended follow-up visits with your eye care professional, usually on an annual basis after the healing of the surgery. Contact your eye care professional immediately if you should experience a problem.

EVO and LASIK costs vary depending on various factors that may include your prescription, location and provider. Upon consultation with an EVO doctor, they will provide you with your specific cost, financing options and payment plans. To speak to a doctor near you, click here.

On Average CDN$14,000 Over Lifetime*

Your personal cost will vary. Because EVO is a long term solution, your procedure costs are generally fixed to a one time-fee. When you compare with the long term costs of contact lenses, EVO pays for itself.

*Popular daily disposable contacts, on average, cost about CDN$730 a year. So over 20 years, a patient will spend CDN$14,000 on contact lenses.

Important Safety Information

The EVO/EVO+ ICLs are designed for the correction/reduction of myopia in adults ranging from -0.5 D to -20.0 D with less than or equal to 6.0 D of astigmatism at the spectacle plane. The Canada EVO models have a spherical power range of -3.0 D to -18.0 D and cylinder power range of 1.0 D to 6.0 D. The Canada EVO+ models have a spherical power range of -3.0 D to -14.0 D and cylinder power range of 1.0 D to 6.0 D. The hyperopic ICL’s are available in powers ranging from +3.0 to +10.0 diopters for the correction/reduction of hyperopia. The ICLs are indicated for patients who are 21 to 60 years of age. In order to be sure that your surgeon will use a ICL with the most adequate power for your eye, your nearsightedness, farsightedness and astigmatism should be stable for at least a year before undergoing eye surgery. ICL surgery may improve your vision without eyeglasses or contact lenses. ICL surgery does not eliminate the need for reading glasses, even if you have never worn them before. ICL represents an alternative to other refractive surgeries including, laser assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), incisional surgeries, or other means to correct your vision such as contact lenses and eye glasses. Implantation of an ICL is a surgical procedure, and as such, carries potentially serious risks. The following represent potential complications/adverse reactions reported in conjunction with refractive surgery in general: additional surgeries, cataract formation, loss of best corrected vision, raised pressure inside the eye, loss of cells on the innermost surface of the cornea, conjunctival irritation, acute corneal swelling, persistent corneal swelling, endophthalmitis (total eye infection), significant glare and/or halos around lights, hyphaema (blood in the eye), hypopyon (pus in the eye), eye infection, ICL dislocation, macular oedema, non-reactive pupil, pupillary block glaucoma, severe inflammation of the eye, iritis, uveitis, vitreous loss and corneal transplant. Before considering ICL surgery you should have a complete eye examination and talk with your eye care professional about ICL surgery, especially the potential benefits, risks, and complications. You should discuss the time needed for healing after surgery.

References

References

1. Patient Survey, STAAR Surgical ICL Data Registry, 2018

2. Sanders D. Vukich JA. Comparison of implantable collamer lens (ICL) and laser-assisted in situ keratomileusis (LASIK) for Low Myopia. Cornea. 2006 Dec; 25(10):1139-46. Patient Survey, STAAR Surgical ICL Data Registry, 2018

3. Naves, J.S. Carracedo, G. Cacho-Babillo, I. Diadenosine Nucleotid Measurements as Dry-Eye Score in Patients After LASIK and ICL Surgery. Presented at American Society of Cataract and Refractive Surgery (ASCRS) 2012.

4. Shoja, MR. Besharati, MR. Dry eye after LASIK for myopia: Incidence and risk factors. European Journal of Ophthalmology. 2007; 17(1): pp. 1-6.

5a. Lee, Jae Bum et al. Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis. Journal of Cataract & Refractive Surgery , Volume 26 , Issue 9 , 1326 - 1331.

5b. Parkhurst, G. Psolka, M. Kezirian, G. Phakic intraocular lens implantantion in United States military warfighters: A retrospective analysis of early clinical outcomes of the Visian ICL. J Refract Surg. 2011;27(7):473-481.

*American Refractive Surgery Council