EVO ICL

Evolution in Visual Freedom

Find out if you're a candidate

What is EVO ICL?

EVO ICL, also called an Implantable Collamer Lens, is a refractive implant to correct common vision issues like myopia (nearsightedness) with or without astigmatism. Unlike some other vision correction options, the EVO ICL is an additive technology that corrects vision without the removal of any corneal tissue. The EVO ICL is meant to reduce or eliminate the need for glasses and contacts and unlike most permanent refractive solutions, EVO ICL is removable by your doctor, for added peace of mind.

EVO ICL Procedure - what to Expect

EVO ICL is made of biocompatible Collamer material that works in harmony with your eye. Your Eye doctor will create a small opening in your cornea that will be used to insert and position the EVO ICL. For most patients, the procedure is virtually painless with numbing drops and it typically takes less then 20 – 30 minutes for both eyes. Patients typically experience improved vision right away and a quick recovery time.

Eye with EVO ICL inserted
Permanent Yet Removable If Needed

Benefits of EVO ICL

• Provides clear, sharp vision
• 20 – 30 minute procedure
• Quick recovery time
• Removable by your doctor
• Offers UV protection
• Not visible once in place

• Can treat nearsightedness with or without astigmatism
• For patients who may not be candidates for LASIK of other vision correction procedure due to thin corneas
• Does not cause dry eye syndrome
• Excellent night vision

Dr. Sudhinder Koushik of LEC EVO ICL procedure success quote

Cost and financials for EVO ICL

The investment in the EVO ICL procedure is more than LASIK and by performing the procedure in our facility that difference is minimized versus having to use an outside facility. Many EVO ICL patients look forward to spending less in the long run with the EVO ICL compared to the continued cost of contacts and glasses. Ask about financing options and payment plans that may be available for your EVO ICL procedure.

Is EVO ICL Right for me?

EVO ICL, is well-suited for a wide variety of people. Ideal candidates for EVO ICL are at least 21 years of age with nearsightedness or without astigmatism and have maintained a stable prescription for at least one year. If you are seeking a solution to decrease or eliminate the cost and frustration of traditional contacts or glasses, EVO ICL may be your answer. Contact us to discuss if EVO ICL is right for you. 

Which Option is Right for ME?

This chart breaks down the general candidacy guidelines for each procedure. During your initial consultation, your eye care professional will discuss your measurements and help you make the right choice depending on your unique vision. 

EVO ICL Chart
Cameron brink evo icl patient

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With Laser Eye Center
of Silicon Valley

Important Safety Information for EVO ICL

The EVO ICL lens is intended to correct/reduce nearsightedness between -3.0 D up to -20.0 F and treat astigmatism from 1.0 D to 4.0 D. If you have nearsightedness within these ranges, EVO ICL surgery may improve your distance vision without eyeglasses or contact lenses, Because the EVO ICL corrects for distance vision, it does not eliminate the need for reading glasses, you may require them at some point, even if you have never worn them before. Since implantation of the EVO ICL is a surgical procedure, before considering EVO ICL surgery you should have a complete eye examination and talk with your eye care professional about EVO ICL surgery, especially the potential benefits, risks, and complications. You should discuss the time needed for healing after surgery. Complications, although rare, may include the need for additional surgical procedures, inflammation, loss of cells from the back surface of the cornea, increase in eye pressure, and cataracts, You should NOT have EVO ICL surgery if your doctor determines that 1. the shape of your eye is not appropriate, 2. you do not need the minimum endothelial cell density for your age at the time of implantations, 3. you have moderate to sever glaucoma, 4. your vision is not stable, or 5. if you are pregnant or using.

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EVO ICL FAQs

General EVO ICL Questions

What is EVO ICL?

 The EVO Implantable Collamer Lens is a soft, flexible lens placed behind the iris and in front of the eye’s natural lens. It corrects moderate to high nearsightedness and astigmatism without permanently removing tissue from the cornea.

 The EVO ICL allows people to see without glasses and contacts (similar to LASIK) but is a different procedure in that no corneal tissue is removed. Patients report excellent quality of vision both during the day and at night. There is no increased risk of dry eye symptoms. If needed in the future, it can be removed by a doctor (e.g., prior to having custom lens replacement or cataract surgery).

Most patients see well within 24 hours. You can generally resume normal activities quickly, and vision continues to refine over the first week.

Many patients see 20/20 or better without glasses. Some may still use glasses for small tasks or for reading later in life due to normal age-related changes.

Yes. The ICL is reversible. If your prescription changes significantly later in life, it can be exchanged for another ICL or removed during cataract surgery.

The EVO ICL is designed to remain in place permanently, but it can be removed or replaced if needed.

Our surgeons perform more EVO ICL procedures on a monthly basis than most surgeons do in a year. We are the leading practice in Northern California and among the top three in the nation based on surgical volume. We believe this level of experience with the procedure leads to better safety, outcomes and satisfaction for our patients.

Safety and Long Term Outcomes

What is the impact of EVO ICL on endothelial cells?
  • Studies show that the EVO ICL does not cause accelerated long term endothelial cell loss.
    • There is a small amount of cell loss during surgery related to surgical manipulation.
    • After healing, the cell loss rate matches normal age-related change.
    • EVO ICL technology has been in global use for over a decade and long term corneal decompensation has not been reported in meaningful numbers.
  • Based on current data and clinical experience, long term endothelial health is not a concern when the procedure is performed properly.
  • Your eye doctor can monitor your endothelial cell density during routine exams.
    • The central cornea is measured using specular microscopy.
    • Density, cell shape, and presence of guttae are evaluated.
    • An annual measurement is appropriate and both MD and OD providers can perform this exam.
  • Monitoring is simple, widely available, and effective at detecting early changes if they occur.
  • Earlier versions of the Visian ICL had some risk of cataract formation due to their design and higher vault requirements. Even so, long-term complications remained uncommon.
  • EVO ICL significantly improved safety by adding a central port and reducing the need for surgical iridotomies. The current device has an excellent long-term safety record.
  • There is no evidence suggesting a high long-term risk with EVO ICL.
  • Although rare, reasons can include:
    • Persistent halos or glare
    • Patient preference
    • Refractive enhancement requiring an exchange
    • Cataract formation later in life (not caused by the ICL)
  • Halos are usually mild and improve with time. Approximately 2 percent of patients are bothered by halos enough to discuss treatment. Removal is very uncommon. If needed, lenses can be removed safely.
  • Brimonidine can temporarily reduce night glare by reducing pupil size.
  • Some halos can occur, especially at night, but most patients adapt well.
    • About 2 percent find them bothersome.
    • Large pupils may increase halo perception, but are rarely a contraindication.

Yes. Our practice has three surgeons based locally in the Bay Area, and someone is always on call. Patients can reach us for urgent issues at any time.

  • Accommodation thickens the natural lens, which can temporarily reduce vault. This is normal.
    • ICL sizes are selected to maintain a safe vault across a range of accommodative states.
    • Studies show that vault reduction during reading does not meaningfully increase cataract risk.
    • Near vision changes that occur with age (presbyopia) do not make the ICL unsafe.

Less than 1 percent. Nearly all cases involve a steroid response to postoperative drops and resolve once the steroid is tapered.

  •  It is extremely secure.
    • EVO ICL is approved for military use and performs safely under high physical stress.
    • Impacts are unlikely to affect the ICL and its positioning.
  • The eye itself protects the lens well.

Diagnostic Testing and Procedure Planning

How do you choose the correct size and power for the EVO ICL?
  • We determine EVO ICL sizing using the clinical trial-proven method of partial coherence interferometry (PCI) and Scheimpflug imaging to obtain precise biometric data of the eye. Additional refinement is applied through a practice and surgeon-specific nomogram, which improves accuracy and allows individualized flexibility.
  • On the day of surgery, we perform a same-day anterior segment OCT size-check, which provides final confirmation and allows refinement of sizing on day of surgery. This combination of PCI, Scheimpflug imaging, customized nomograms, and same-day OCT allows for highly accurate sizing predictions and reliable post-implantation confirmation or adjustments if needed.

Yes. EVO ICL is able to treat up to 4.00 diopters of astigmatism. Additional astigmatism can be addressed beyond 4.00 diopters with the surgeon’s technique and combined laser vision correction.

The EVO ICL is ordered individually and specifically for each patient, based on the exact prescription we are aiming to correct, as well as the specific size based on each person’s anatomy. The ICL implantation is also specific to each individual. 

All procedures are performed in our state-of-the-art operating suite. It is in the same facility where your consultation, exam, and all appointments take place. We have two locations: San Jose and Pleasanton. Most practices offering the procedure require patients to go to an external facility, typically an ASC (ambulatory surgery center) or hospital. The same people you meet during the consultation are involved as the team on the day of your procedure. Our patients tell us they truly appreciate the convenience and familiarity of our environment.

Pregnancy, Postpartum, and Breastfeeding

Can I have ICL surgery while pregnant?

No. Pregnancy can alter your prescription and corneal biomechanics, and sedation and postoperative medications are not recommended during pregnancy.

  • Vision can fluctuate for several months postpartum. If you are not breastfeeding, you may be able to proceed once your prescription is stable.
  • If you are breastfeeding, a conservative recommendation is to wait at least 3 months postpartum and confirm refraction stability with repeat measurements.

Possibly, but only if your refraction is clearly stable. Breastfeeding hormones can still cause temporary prescription shifts. Surgery can be considered if stability is documented and you understand medication precautions.

Not usually. However, dryness is more common postpartum and during lactation, so tear film should be evaluated before surgery.

  •  Valium passes into breast milk.
  • For a single preoperative dose, most guidelines suggest pumping and discarding milk for 24 hours afterwards to prevent infant sedation.
  • Alternative anxiety management strategies are available.
  • Yes:
    • Moxifloxacin drops have minimal systemic absorption.
    • Prednisolone acetate drops are also safe in ophthalmic doses.
  • Perform punctal occlusion by pressing on the inner corner of the eyelid for 1 to 2 minutes after each drop to reduce absorption even further.
  • You do not need to pump and dump because of these eye drops.

Pregnancy may cause temporary refractive shifts, even with an ICL in place. These variations usually resolve after pregnancy and breastfeeding. The ICL itself remains safe and stable.