Surgical Co-Management · Refractive
EVO ICL Guide a phakic lens for patients lasers may not fit.
The EVO and EVO+ Visian Implantable Collamer Lens from STAAR Surgical sits behind the iris and in front of the natural lens. It corrects myopia and myopic astigmatism without removing corneal tissue or the crystalline lens, which makes it a referral option for high myopes and for corneas that are poor laser candidates.
Quick answer
Lens-based correction that leaves the cornea alone.
STAAR describes the ICL as a reversible, lens-based approach: the cornea and natural lens are preserved. In February 2026 the FDA expanded the U.S. age indication from 21 to 45 up to 21 to 60. The referring practice identifies candidates, especially high myopes and thin or irregular corneas, and follows them after implantation.
Key takeaways
- Indicated for myopia of −3.0 to −20.0 D spherical equivalent.
- The toric version treats myopic astigmatism with 1.0 to 4.0 D of cylinder.
- Approved age range is 21 to 60 years.
- No corneal tissue is removed.
- Post-op care watches pressure, lens position and the natural lens.
Where the ICL fits among refractive options.
A comparison by what each procedure changes. The surgeon makes the final call.
| Procedure | What changes | Natural lens |
|---|---|---|
| LASIK | Excimer ablation under a corneal flap | Kept |
| PRK | Excimer ablation of the corneal surface | Kept |
| SMILE | Femtosecond lenticule removed through a small incision | Kept |
| EVO ICL | Implantable lens added behind the iris | Kept |
| Refractive lens exchange | Natural lens replaced with an IOL | Removed |
The co-managing role.
What the referring practice can own before and after implantation.
- Identify high myopes
- Document stability
- Shared follow-up plan
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Candidate search
High myopes who were told they are not LASIK candidates are the obvious first group.
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Stable refraction
Bring serial refractions and keratometry to the referral.
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Pressure and position
Check intraocular pressure and lens position at follow-up as directed by the surgeon.
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Long-term
Patients keep their natural lens, so they age into presbyopia and cataract like any other patient.
Search your records for patients with spherical equivalents beyond −6.00 D who are between 21 and 60. That list is the starting point for an ICL conversation.
Frequently asked questions
What changed in 2026?
In February 2026 STAAR announced FDA approval of an expanded U.S. age indication, from 21–45 to 21–60.
What prescriptions are covered?
Myopia with a spherical equivalent of −3.0 to −20.0 D, and myopic astigmatism with 1.0 to 4.0 D of cylinder, at the spectacle plane.
Is the lens removable?
STAAR describes it as a reversible, lens-based approach. Removal decisions belong to the surgeon.
Where does the lens sit?
Behind the iris and in front of the natural crystalline lens.
References
- STAAR Surgical. FDA expands U.S. age indication for EVO ICL, February 17, 2026. Business Wire
- STAAR Surgical. U.S. FDA approval of EVO Visian ICL, March 28, 2022. Business Wire
- Every source behind this guide is listed on the Vision Rescue sources page. All sources
About this guide
Written for licensed eye care practices by the Vision Rescue team from manufacturer, FDA, CMS and peer-reviewed sources. Questions: providers@visionrescue.com or 1-855-692-8024.
Important notes and disclosures
Information only. Candidacy, technique and outcomes are decided by the operating surgeon. Co-management arrangements must follow federal and state law. Vision Rescue is a licensed pharmaceutical wholesale distributor.
Bring high myopes back into the conversation.
Patients told years ago that they were not laser candidates may have a lens-based option now.
EVO, EVO+, Visian, ICL and Implantable Collamer Lens are trademarks of STAAR Surgical. Review the directions for use for indications, contraindications and risks.