The Visian EVO ICL (Implantable Contact Lens)

Introduction

Established for over 20 years with over 800,000 procedures, the Visian EVO Implantable Collagen (Collamer) Lenses (ICL) has been in regular use at Centre for Sight since 2002.

The procedure involves implantation of micro-thin lenses inside the eye to correct, short-sightedness (myopia), far-sightedness (hyperopia) and astigmatism. The procedure which can be reversed is able to treat a high range of correction beyond that possible with laser eye surgery.

It is an excellent alternative to laser eye surgery and where Lasik is contraindicated, for instance those with thin or abnormal corneas, Keratoconus [REF 1] and dry eye.

Overview

Micro-thin implant as an alternative or for those not suitable for laser vision correction

  • Suitable for those who have –
    • Shortsightedness from -0.50 to -20.00
    • Farsightedness from +0.50 to +10.00
    • Astigmatism from 0.50 to 6.00
    • Aged between 21 and 60 years old
  • “Additive” surgery – so can be reversed
  • Positioned behind the iris and in front of the natural lens
  • 20+ year track record
  • Over 800,000 implanted worldwide
  • Useful in Keratoconus and dry eye where laser vision correction is contraindicated
EVO Visian ICL implanted cross section position 2

Indications

The ICL is used for vision correction for shortsightedness (myopia) from -0.50 to -20.00 D and farsightedness (Hyperopia) from +0.50D to +10.00D. Toric ICL implants correct astigmatism from 0.5D to 6.00D.The ICL can be used as an alternative to Lasik Laser eye surgery and has the advantage of being “Additive” and can therefore be reversed. The levels that can safely be corrected are much higher than Laser eye surgery.

ICL is a good option for those with Dry eye, Keratoconus, those who have thin corneas or abnormally shaped corneas including those who have had corneal transplants.

Special Characteristics

Biocompatible Implantable Contact Lens

Lens Material

The Lens is made of “Collamer” which is derived from Collagen, a natural material which is makes up the bulk of the human body. This is bio-compatible, in other words is not considered foreign tissue and is not “rejected”.

UV Protection

UV protection

The Visian EVO ICL Collamer material has built in UV protection for the eye.

Some patients have large pupils and thus more susceptible to halos and glare. Where possible the EVO+ lens which has an expanded optical zone size is used in order to avoid these symptoms

ICL - Additive, Removable Procedure

Additive, Removable Procedure

It can permanently correct your vision, yet no natural tissue is removed. It can be removed if for the unlikely event you need or wish to remove your ICLs in the future.

Implantable Contact lens - Quick procedure and recovery

Quick Procedure & Recovery

ICL procedure is painless and quick being minimally invasive. Most patients are able to resume daily activities in just a few days with clearer vision.

Finding out if you are suitable for Visian EVO ICL

Suitability for the procedure is best determined at consultation where specific tests and eye dimensions are measured. Generally the procedure is suitable for those who are shortsighted from -0.50 to -20, farsightedness from +0.50 to +10.00, have astigmatism from 0.50 to 6.00D and aged between 21 and 60 years old. This link which has a series of 10 simple questions will guide what vision correction options are available for you:

The Consultation

The purpose of the consultation is to a) ensure suitability for surgery and b) plan the procedure with the absolute correct dimensions and correction. The process involves a very thorough evaluation by nurses, optometrists and technicians who will perform a series of tests and investigations specific for the Visian ICL procedure. These include Specular microscopy to measure the corneal endothelial cell count, anterior segment imaging and biometry to measure the dimensions of your eye to ensure there is enough space and that the configuration is suitable to receive a Visian ICL as well as determine the size of the implant.

You will be provided further information about the procedure and shown video animations. Your surgeon will give you an explanation of what is involved and what to expect.

You will then be seen by a well experienced fellowship trained consultant who will evaluate your eyes and come to a final decision. The consultant will inform you about your suitability and also provide you with an informed consent.

If you are lucky enough to be suitable and wish to proceed, you will need to confirm a date and pay a deposit for the lenses which have to be ordered from Switzerland. If you have astigmatism or keratoconus, special bespoke lenses may have to be made for you and these can take about 6 weeks to manufacture (sometimes longer depending on the prescription).

Consultation Centre for Sight

The Procedure

Both eyes can be treated on the same day, however your consultant will decide if this is an option for you or not. Your consultant may choose to treat one eye at a time and perform the other 2 days later.On the day of surgery, dilating and strong anaesthetic drops are instilled in the eye, and a sedative is provided either orally or through your veins. The procedure involves folding the lens in a lens insertion device and implanting the curled up lens through a tiny incision (2.8mm). The lens is then positioned behind the iris and rotated into the correct position if an implant for astigmatism is used (Toric ICL). Medication to constrict the pupil is inserted as well as antibiotics to prevent infection.

One hour later you will be examined to check your vision and pressure. The surgeon will also examine the eye to make sure all is well before you go home. You will be seen again the following day. To help the eye heal, steroid and antibiotic eye drops will need to be taken four times daily decreasing by one drop each week.

Aftercare & Recovery

You will be seen again at one month and a series of investigations will be performed to ensure your lens is stable. If felt necessary or if you have any concerns, you can be seen earlier.Vision is typically very good the day after surgery and improves further with time. The eye drops are very strong and can affect the eye surface and cause symptoms of dry eye and may temporarily affect vision. This will improve once the drops are stopped, however it is important that these be used as instructed.

While the vast majority of patients are absolutely thrilled with their visual outcome, for a very small number obtaining good vision can be quite a shock and also different from vision with glasses and contact lenses.

This initial change is something that eventually all patients adapt to and are ultimately thrilled with their visual freedom. We understand all patients are different and respond differently and at Centre for Sight we pride ourselves in looking after our patients well.

Long Term Care

We advise ALL patients to be seen by ourselves or other surgeons well versed with Visian ICL surgery annually. While the implant does not change the human eye does change, in particular the crystalline lens and it is best to be monitored regularly.

Risks & Complications

All surgical procedures carry risk however the benefits of Visian ICL EVO surgery far outweigh some of the alternatives. Surgery performed by a well experienced and competent surgeon will reduce risks.Centre for Sight surgeons have implanted this lens since 2002 and make considerable efforts to ensure patients are suitable, the lens size and power are optimised for each eye and surgery is performed to an exemplary standard in the best possible environment.

Cataract

Cataract formation is a potential risk if the implant were to damage the crystalline lens during the procedure.

Infection

Infection is a possibility in every operation but very rare in Visian ICL surgery [REF 2]. At Centre for Sight we are pleased to state we have not had a proven infection following ICL surgery.

High intraocular pressure

This can occur from a ‘steroid response”. The pressure in some individuals can go up following surgery from the steroid eye drops that are provided. This is rare and patients are advised to call if they experience a headache or eye ache and/or visual disturbance.

High pressures can occur from pigment dispersion where early after the procedure the iris rubbing against the ICL can release pigment. In theory this can cause raised eye pressure from a blockage of the draining system. Although pigment dispersion has been seen transiently in our patients, this has not to date led to high pressures requiring treatment.

FAQs

What will I feel during the ICL procedure?

Surgery is performed using strong anaesthetic eye drops and do not experience any discomfort. They receive sedation either orally or intravenously and this usually takes away any anxiety. After surgery there may be a slight foreign body sensation when blinking and this is from the edge of the micro-incision which quickly settles.

If my vision is still not corrected, can I have a re-treatment?

An under or overcorrection is rare and if this is present and affects vision then if suitable additional laser vision correction surgery can be performed once the eyesight has stabilised for a few months.

Does Health Insurance cover payment for Visian ICL EVO surgery?

No. Visian ICL surgery is a refractive procedure (like PRK/LASIK) and is considered an elective lifestyle improvement, as opposed to medical necessity (like for instance cataract surgery). In some cases individual insurance plans may offer a partial benefit that can save you money on the cost of the procedure, and you are advised to check with your insurance company or employer prior to the procedure.

Prices

The prices are an indication of usual charges. The information here is not complete and may be subject to change. Please read in conjunction with the Centre for Sight Terms and Conditions.

Consultation – reduced price for payment in advance of consultation £350
Implantable Contact Lens ICL – Non Toric £3,350 per eye (from £86 per month)*
Implantable Contact Lens ICL – Toric £3,675 per eye (from £93 per month)*

*per eye with 0% interest finance option payable over 24 months. Deposits will apply.

Deposits

Since the ICL lenses are ordered specifically for each eye, a deposit is required. The deposit is included in the final price and is non-refundable.

For laser vision correction consultations, we request the payment to be completed at the time of booking consultation. 

Visian ICL EVO surgery cost package includes:

  • The cost of procedure
  • Reassuring 24 hour service
  • Inclusive follow-up care for up to 6 months
  • Top- up laser eye surgery if required
  • Patients who have had ICL are advised to be seen annually the cost of which is £295 and includes all necessary investigations related to ICL

Finance Options

Centre for Sight has partnered with V12 Finance, to make the cost of implantable contact lens surgery and remarkable care affordable.

Our attractive 0% APR (representative) repayment option is available over 24, 18 and 12 months, subject to application.

A deposit payment will be required. If you wish to pay a larger deposit, even lower monthly finance rates are available, all interest-free.

Centre for Sight is an Introducer Appointed Representative of V12 Retail Finance Limited. Registered in England and Wales 4585692. Correspondence address: 20 Neptune Court, Vanguard Way, Cardiff, CF24 5PJ. Registered Office: One Arleston Way, Solihull, B90 4LH. V12 Retail Finance Limited act as a credit broker and introduces to one or more lenders, for which they will receive a commission.

V12 Retail Finance is a trading name of Secure Trust Bank PLC. Both are authorised and regulated by the Financial Conduct Authority. Centre for Sight will not receive a commission for making introductions to V12.

Credit acceptance is subject to application and status. Other terms and conditions apply and will be advised upon acceptance.

Related Information

Other helpful websites

  1. EVO Visian ICL https://uk.discovericl.com/
  2. Short-sightedness – Eyes and sight information. Professor Simon Taylor, Consultant Ophthalmic Surgeon. BUPA https://www.bupa.co.uk/health-information/eyes-sight/short-sightedness 

Sources & References

  1. Kamiya K, Shimizu K, Kobashi H, Igarashi A, Komatsu M, Nakamura A, Kojima T, Nakamura T. Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for the correction of high myopic astigmatism in eyes with keratoconus. Br J Ophthalmol. 2015 Feb;99(2):177-83. doi: 10.1136/bjophthalmol-2014-305612. Epub 2014 Aug 21 PubMed
  2. Allan BD, Argeles-Sabate I, Mamalis N. Endophthalmitis rates after implantation of the intraocular Collamer lens: survey of users between 1998 and 2006. J Cataract Refract Surg. 2009 Apr;35(4):766-9. doi: 10.1016/j.jcrs.2008.12.027. PubMed PMID: 19304102. PubMed

Author Information

Authored by Sheraz Daya MD FACP FACS FRCS(Ed) FRCOphth, Consultant Ophthalmic Surgeon & Medical Director, January 2019.

Mr Daya is the Medical Director of Centre for Sight and has been a consultant to Staar Surgical Inc. manufacturer of the Visian ICL EVO lens.  He was listed amongst the 100 most influential ophthalmologists in the world ( https://theophthalmologist.com/power-list/2018/sheraz-daya/) and the Daily Mail’s Good Surgeon Guide as among UK’s best cataract surgeons (https://www.dailymail.co.uk/news/article-5796781/Meet-best-cataract-surgeons-Britain-learn-treatments-used-improve-sight.html).

As an authority and leader in refractive surgery he has served on the Royal College of Ophthalmologists Refractive Surgery Working Group which developed the Standards for Refractive surgery including Implantable Contact Lenses /Phakic IOL (https://www.rcophth.ac.uk/wp-content/uploads/2016/03/ToR-Refractive-Surgery-Standards-Working-Group-V1.4.pdf )

Next review due January 2020.