What is EVO Visian ICL?
EVO Visian ICL is a phakic implantable collamer lens. Phakic means that your natural lens of the eye is not removed. Collamer is a biocompatible material made of collagen and polymer that won’t cause dry eyes after implantation.
The EVO Visian ICL is positioned inside the eye between your iris and your natural lens. It’s an additive lens that doesn’t require reshaping the cornea or removing the natural lens to correct your vision.
You can have it removed at any time, including if your vision worsens and you need a procedure like cataract surgery in the future to have an IOL implanted. For patients with astigmatism, the EVO Visian ICL also comes in a toric model.
Benefits of EVO ICL
- EVO ICL is biocompatible and corrects high levels of myopia (nearsightedness) as well as astigmatism
- The insertion of the EVO ICL is a quick procedure, taking only 20 to 30 minutes to complete
- Not having to worry about seeing or feeling the EVO Visian ICL after it’s in place
- No minimum corneal thickness requirement, in contrast to LASIK and PRK.
- Does not cause dry eyes or worsen symptoms of dry eye syndrome
- Protects the eye from ultraviolet radiation as it sits in front of your natural lens
- Provides improved night vision and contrast sensitivity when compared to LASIK
- With EVO ICL there is no permanent change to the eye structure, with no corneal flap or reshaping of the eye.
- With EVO Visian ICL there is peace of mind that the ICL can be removed at any time
Limitations of EVO ICL
- Can only treat myopia and astigmatism. With LASIK you can also treat hyperopia.
- Must be between 21 to 45 yo, however, with LASIK, surgery can be done with those over the age of 18.
- The recovery after ICL is slightly longer than LASIK but is generally quite smooth. You can return to your normal activities almost immediately but will need to use special eye drops for a month following your procedure. After two weeks, you should be fully healed.
Risks of Implantable Contact Lens
Generally, the ICL procedure is very safe. However, as with any procedure there are some inherent risks. With the EVO ICL the risks include:
- Vision loss due to increased intraocular pressure
- Glaucoma
- Blurry vision due to under or over correction
- Cloudy cornea
- Retinal detachment
- Eye infection
Comparison chart EVO ICL versus other Vision Corrective Procedures:
EVO ICL
LASIK
EpiLASIK
CLE
Recovery Time
Quick
Quick
Almost 1 Month
Quick
Immediate Visual Acuity
Quick
Quick
Slowly Gets Clearer
Quick
Dry Eyes
No
Possible
Possible
Possible
UV Protection
Yes
No
No
No
Removable
Yes
No
No
No
Myopia
Yes
Yes
Yes
Yes
Astigmatism
Yes
Yes
Yes
Yes
Hyperopia
No
Yes
Yes
Yes
What to expect:
Before Surgery
You will come in for a consultation and discuss whether the EVO IOL is the best option for you. . If so, multiple measurements of the eyes length and shape will be made to determine the exact power of the lens needed. If you wear contact lenses you will need to wear glasses and be out of your contact lenses for several weeks so we can get the most accurate measurements of your eye. The doctor will go over the surgery and answer your questions. You will need an adult to drive you home after your procedure.
The Day of Surgery
You will be given drops to numb your eyes and iv sedation to calm you down. Dr. Mudgil will insert a small ICL in each eye. Even though the procedure will take about 15-20 minutes, you can expect to be at the surgery center between 2-3 hours.
After Surgery & Beyond
After the procedure you will go home wearing sunglasses or a protective eye shield and will need someone to drive you home. You may have some feeling of scratchiness or mild discomfort for which you can take an over-the-counter pain reliever. After two weeks, you should be fully healed. You should see improvement within 24 hours of the procedure. You can return to your normal activity after the procedure but will require eye drops for approximately a month following your procedure. You will follow up the next day and again one week later.
The result of the ICL surgery will last for a long time, till your vision begins to change from conditions such as presbyopia or cataract, which are often associated with normal aging. During your cataract surgery the surgeon may consider removing the ICL and replacing your natural lens with a new implant.
What is LASIK & EpiLASIK?
LASIK and epiLASIK are the two most common laser vision correction procedures performed. LASIK involves using a femtosecond laser to create a partial thickness flap in the cornea, followed by using an excimer laser to change the shape of the remaining cornea to correct the refractive error. Following the laser applications, the flap is reflected back into place. The vision usually improves over the next day, but it will continue to heal/improve over the next 3 to 6 months. The patient can typically return to work the day after surgery.
On the other hand, epiLASIK doesn’t involve creating a corneal flap. Rather, a device called epikeratome is used to remove the epithelium layer of the cornea, like peeling and discarding a small disc (about 9mm) of onion skin. The excimer laser treatment is then applied directly onto this exposed corneal surface. Following this, an antimetabolite agent known as mitomycin-C may be applied to prevent future corneal haze/scarring. Finally, a high-oxygen permeable clear contact lens is then placed on the treated cornea to conclude the surgery. Typically, over the next 3-4 days, the epithelial cells re-grow over the treated surface, after which the contact lens is removed. The patient can return to work about one to two days after the contact lens is removed.
Because of the additional healing time, epiLASIK is a less convenient procedure than LASIK. Some people can have pain and light-sensitivity for 2 or 3 days after surgery. It also takes longer for the vision to recover while the surface is healing. Some days can be good and other days more blurry. Over time this levels out, eventually getting to the same vision result as LASIK, but epiLASIK takes longer to get there.
However, since there is no flap with epiLASIK, some consider it to be the safest laser vision procedure available. Indeed, most laser vision correction complications today are flap related, and epiLASIK eliminates this element (albeit small) of risk.
epiLASIK may be more appropriate for certain patients who may not qualify for LASIK due to their corneal thickness or high prescription. When we create a flap on the cornea with LASIK and then remove additional corneal tissue with the excimer laser, only the remaining cornea provides bio-mechanical strength for the eye moving forward. Because of this, if the estimated remaining cornea is projected to be too thin, we become worried that the remaining corneal tissue may not provide enough support to keep the eye and the prescription stable throughout the patient’s life. This is typically the case if the estimated remaining corneal tissue is projected to be thinner than 250 microns, in which case the patient is not a candidate for LASIK. In this instance, the patient could qualify for epiLASIK, which typically saves an additional 120 microns of corneal tissue, allowing for a safe and excellent vision-correction outcome. In general, a patient who is a candidate for LASIK is always a candidate for epiLASIK, but not the other way around.
There are additional unique reasons a patient may be better suited for one procedure over the other, but such considerations would be reviewed at the consultation visit as indicated. A benefit of laser vision correction at Mudgil Eye Associates is that we are the only practice in Chester County capable of offering both procedures, allowing us to cater the best treatment for your eyes!
Why get LASIK at Mudgil Eye Associates?
At Mudgil Eye Associates, our doctors use the latest All-Laser technology for LASIK. This is in contrast to traditional LASIK, where a blade (known as microkeratome) is used to cut the corneal flap that is necessary for laser application. With the All-Laser method, only a laser is used to create the corneal flap; a blade is never used. This laser technique allows for greater precision, effectiveness, and safety in the LASIK procedure. The benefits of the All-Laser LASIK procedure over traditional LASIK include:
- Decreased patient anxiety
- Stronger flap after recovery
- Improved safety and risk reduction
- Reduced post-operative complications
- Improved quality of vision
- Increased precision in flap creation
At Mudgil Eye Associates, in contrast to other practices, because our primary concern is patient safety, we have never charged more for the All-Laser method, despite its being a more sophisticated and technologically intensive procedure.
All-Laser Technology
LASIK FAQ's
Today’s laser vision correction is capable of treating a much broader range of nearsightedness, farsightedness, and astigmatism than ever before. With all-laser LASIK technology and epiLASIK options, the overwhelming majority of patients will be candidates based on refractive error. Nonetheless, your candidacy also depends on your ocular and general medical health. Be sure to mention to our doctors all your current health issues, past medical and ocular history, and current medications. The best candidate is in good health, at least 21 years old, and has a stable refraction for at least one year. The best way to determine if you are a candidate is to take advantage of our complementary LASIK consultation.
Mudgil Eye Associates is well known for offering extraordinary care for a broad spectrum of ophthalmological issues. We have performed thousands vision correction procedures of all types. Many of our referring physicians throughout the Chester County community have trusted us to perform surgery on themselves and their families. Our physicians have been recognized as Top Docs by Castle Connolly and Main Line for over a decade. We are also the only practice in Chester County with the expertise to offer the broadest spectrum of advanced laser vision correction procedures: both epiLASIK and all-laser LASIK.
While there are very few patients that are not candidates for traditional LASIK, we have options for vision correction for those who are not suitable candidates. These options would be discussed after a comprehensive consultation, and they can include:
- PRK
- epiLASIK
- Clear Lens Exchange with the following intraocular lens (IOL) options:
- Crystalens
- Multifocal IOL
- Toric IOL
Laser vision correction has been performed in the United States since the mid-1990s, with excellent results. The vast majority of patients with low to moderate myopia achieve better than 20/40 acuity, such that they will not legally require glasses for driving. Most patients achieve 20/20 or better acuity. Some patients can need an enhancement procedure to ‘touch-up’ the initial outcome. Nonetheless, the goal of LASIK is to reduce dependency on glasses or contact-lenses. As the eye ages, many will eventually still need glasses for reading.
The need for reading glasses as we reach into our 40s is called presbyopia. This has to do with aging changes in the lens of the eye. Because LASIK does not treat the lens of the eye, it cannot be used to directly treat presbyopia. Nonetheless, many undergoing LASIK may elect for monovision, where one eye is corrected for full distance and the other eye for the near/intermediate range. This will reduce the need for reading glasses too. At your LASIK consultation, we will assist you in determining if this is an appropriate option for your condition.
LASIK is by far the most rapid vision correction procedure. It is not an intraocular procedure, so there are no incisions made into the eye. Therefore, topical drops are used to adequately numb the eye, and there is no pain. Most patients will feel a sensation of pressure when the flap is created, but this is very brief. Dr. Mudgil talks to the patient the entire duration of the procedure, advising the patient of what to feel or expect, allowing for a more relaxed experience.
Like LASIK, epiLASIK is also very rapid vision correction procedure. It is performed on an even more superficial layer of the cornea, as there is no corneal flap created. The procedure is performed after the eye is numbed with topical drops, and there is no pain intraoperatively. A clear contact lens is placed after the procedure to keep the eye comfortable. However, unlike LASIK, the eye(s) will be scratchier, light-sensitive, and watery for 3-4 days, and patients are advised to take a week off from work while these symptoms abate.
Laser vison correction is considered a cosmetic procedure, and it is not covered by traditional insurances.
YES! FSA funds are an excellent way to make your laser vision correction procedure more economical.
The overwhelming majority of patients who have had LASIK are extremely satisfied with their results and indicate they would recommend the procedure to family and friends. However, as with any surgical procedure, for certain patients the outcome of LASIK may not meet all their expectations. The risk of actual LASIK complications is estimated at less than one percent.
At Mudgil Eye Associates, a thorough examination and discussion with the surgeon occurs prior to the procedure. Each patient is informed of the risks and benefits of laser vision correction and needs to feel comfortable that he/she is making an educated decision based upon facts. Additionally, unique complication risks that may pertain to your specific case are reviewed in detail.
Although rare, some general complications and side-effects associated with LASIK or epiLASIK include:
- Over or under-correction of vision
- Dry eye syndrome
- Infection or inflammation that can lead to vision loss
- No guarantee of perfect vision
- Device malfunction during surgery
- Loss of best corrected acuity
- Need for further procedures
For a comprehensive discussion of risks, please refer to our consent form, provided at the time of your consultation.
LASIK vs. epiLASIK: which is better for you?
At Mudgil Eye Associates, LASIK and epiLASIK are the two most common laser vision correction procedures performed. LASIK involves using a femtosecond laser to create a partial thickness flap in the cornea, followed by using an excimer laser to change the shape of the remaining cornea to correct the refractive error. Following the laser applications, the flap is reflected back into place. The vision usually improves over the next day, but it will continue to heal/improve over the next 3 to 6 months. The patient can typically return to work the day after surgery.
On the other hand, epiLASIK doesn’t involve creating a corneal flap. Rather, a device called epikeratome is used to remove the epithelium layer of the cornea, like peeling and discarding a small disc (about 9mm) of onion skin. The excimer laser treatment is then applied directly onto this exposed corneal surface. Following this, an antimetabolite agent known as mitomycin-C may be applied to prevent future corneal haze/scarring. Finally, a high-oxygen permeable clear contact lens is then placed on the treated cornea to conclude the surgery. Typically, over the next 3-4 days, the epithelial cells re-grow over the treated surface, after which the contact lens is removed. The patient can return to work about one to two days after the contact lens is removed.
Because of the additional healing time, epiLASIK is a less convenient procedure than LASIK. Some people can have pain and light-sensitivity for 2 or 3 days after surgery. It also takes longer for the vision to recover while the surface is healing. Some days can be good and other days more blurry. Over time this levels out, eventually getting to the same vision result as LASIK, but epiLASIK takes longer to get there.
However, since there is no flap with epiLASIK, some consider it to be the safest laser vision procedure available. Indeed, most laser vision correction complications today are flap related, and epiLASIK eliminates this element (albeit small) of risk.
epiLASIK may be more appropriate for certain patients who may not qualify for LASIK due to their corneal thickness or high prescription. When we create a flap on the cornea with LASIK and then remove additional corneal tissue with the excimer laser, only the remaining cornea provides bio-mechanical strength for the eye moving forward. Because of this, if the estimated remaining cornea is projected to be too thin, we become worried that the remaining corneal tissue may not provide enough support to keep the eye and the prescription stable throughout the patient’s life. This is typically the case if the estimated remaining corneal tissue is projected to be thinner than 250 microns, in which case the patient is not a candidate for LASIK. In this instance, the patient could qualify for epiLASIK, which typically saves an additional 120 microns of corneal tissue, allowing for a safe and excellent vision-correction outcome. In general, a patient who is a candidate for LASIK is always a candidate for epiLASIK, but not the other way around.
There are additional unique reasons a patient may be better suited for one procedure over the other, but such considerations would be reviewed at the consultation visit as indicated. A benefit of laser vision correction at Mudgil Eye Associates is that we are the only practice in Chester County capable of offering both procedures, allowing us to cater the best treatment for your eyes!
Pre & Post-Op Care:
How to schedule a consult:
Schedule a consultation visit to determine if you are a suitable candidate for either epiLASIK or LASIK. To help us, you need to do the following:
- Bring your glasses and contact lens boxes, so we can see your current prescriptions
- Stop wearing contact lenses as follows
- Soft lenses: stop 2 weeks before the appointment
- Hard lenses: stop 4 weeks before the appointment
- Bring your entire list of medications, including those used only as needed
- Complete our new patient questionnaire
What to expect post-operatively:
Post-operative office visits are included in the cost of your laser vision correction procedure. There is always a post-operative day #1 visit. Following this, there is usually a visit somewhere between day #3 to #5. Subsequently, the visits will be much more flexible and depend on the rate of healing; there is usually a visit scheduled at week #2 and around week #4. Many LASIK patients are able to return to work in 1-2 days, while epiLASIK patients need to take a full week off work. Eye make-up can be resumed once off steroid drops, typically around week 2-3 depending on healing. Swimming may also be permitted once off steroid drops.