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EVO ICL

in San Antonio, Texas

EVO ICL surgery in San Antonio is a great solution for many people seeking to see life without glasses and contacts holding them back. If you are seeking a vision solution that will put an end to the hassle and ongoing cost of glasses and contact lenses, the EVO ICL may be right for you. Parkhurst NuVision is one of the most experienced EVO ICL surgery centers in all of North America; over the past 10 plus years, our vision correction surgeons have helped thousands of patients get out of glasses and enjoy crisp, clear vision with ICL surgery. Dr. Gregory Parkhurst is widely recognized as a leading ICL surgeon worldwide.

"Parkhurst NuVision has been a really great experience! I was tired of my glasses and contacts. I'm so glad I got the ICLs."

Mike C.

What is the EVO ICL?

EVO ICL is a microscopic lens made of collagen that is placed by a surgeon so people can just wake up and see. With the ICL (implantable collamer lens), you could be the next bionic man or woman, LOL! But seriously, it’s made of collagen so you can’t feel it or see it in the mirror, and it’s in sync with your body chemistry so your immune system doesn’t even know it’s there. EVO ICL’s are for people who want to see without glasses and contacts, even if they’ve been told they can’t have LASIK. Not a LASIK candidate? Not a problem for EVO.

EVO ICL FDA Approval

The EVO procedure has been in approval studies for the past several years in the United States, and on March 25, 2022, the EVO lens surgical procedure was FDA approved for widespread use in the United States. With over a million EVO Visian ICL’s done outside the US, people in the states finally have access to this “EVO”lutionary procedure.

During approval research trials, the eye doctors at Parkhurst NuVision performed more EVO Visian ICL procedures than any other eye surgery practice in the country, so we are uniquely experienced with this innovative procedure. Thanks to our vast experience and the impressive global patient satisfaction rates, we know that EVO ICL is proven to be safe and effective, even for people with high prescriptions, thin corneas, astigmatism, and/or dry eyes.

Visian ICL

The Visian ICL, the EVOs predecessor, is the eye surgery Dr. Parkhurst has recommended to many of his patients over the years, and it was the procedure he and his wife Heather selected for her eyes back in 2009. Our patients who have had EVO ICL are some of our happiest patients, often due to the self-esteem boost that comes from getting out from behind their thick, often foggy or smudgy glasses.

"I was the type of person who needed their glasses for everything-- literally, if i could have, I would have worn them in the shower if it were possible. I got the Visian ICL surgery and I am in love! I was instantly able to see right after the procedure. Now I can wake up and see without having to search for my glasses, and I'm not so dependent on glasses and contacts anymore! I would strongly recommend this surgery and facility to family and friends."

Marielle

EVO ICL Vision

In the US FDA study Dr. Parkhurst led as principal investigator, the average vision result was actually better than 20/20. Some would call that “supervision,” and an astounding 99.4% of people in a recent study said they would do it all over again, no regrets.

We published in the medical literature on the sharpness and clarity of vision the ICL can provide using what’s called the Rabin supervision test. It’s the night vision quality and contrast sensitivity that really sets the EVO ICL family of lenses apart. People typically say this is the best vision they’ve ever had, so there’s no compromise in vision clarity just to be able to see without glasses and contacts. On average, the unaided vision with EVO ICL is actually demonstrably better than how people have seen with their glasses and contacts in the past.

LASIK may have more name recognition, but EVO is a great solution for patients who have thin corneas, dry eyes, and/or high levels of nearsightedness1.

Dr-Parkhurst-EVO-Benefits-Video

Benefits of the EVO ICL

Benefits of the EVO procedure include fewer office visits on the journey to NuVision! The EVO ICL is an updated Collamer lens that eliminates the need for a pre-surgical prep-step that was necessary with earlier versions of the ICL. If you are seeking vision correction for nearsightedness with or without astigmatism, the EVO ICL is a flexible solution that may be right for you. You can start and finish the process in as little as 24-48 hours. Other benefits include:

Complications and Possible Risks

Risks and potential complications of EVO ICL surgery include increased IOP, the potential for under correction or overcorrection, and the need to reposition or replace an EVO ICL if it were slightly too large for the eye or slightly too small for the eye or if it moved or rotated. The beauty of the EVO procedure is that risks and complications are greatly reduced from prior models of phakic IOL‘s including the Visian ICL predecessor. The EVO ICL has a series of 5 fenestrations (openings) that permit what is called aqueous humor to flow and “bathe” the natural lens of the eye with nutrition and metabolic exchange. This has been shown to reduce the risk of a complication of prior phakic IOL’s, which is the early development of a certain type of cataract called an anterior subcapsular cataract.

With the addition of the fenestrations to the ICL platform found with EVO, the lens is effectively floating, or “hovering”, over the natural lens similar to the puck on an air hockey table. This matters because it minimizes the touch to the natural lens and maintains physiologic-metabolic flow and is therefore “in-harmony” with the eye’s body chemistry, virtually eliminating the prior risk of cataract formation. The fenestration also eliminates the risk of a certain type of glaucoma called “pupil block,” which was a very rare potential complication of prior phakic IOL’s. Since there are openings in the EVO ICL itself, there is no risk of pupil block glaucoma, meaning there is no need for additional laser treatments to adjust the intraocular pressure postoperatively. This simple modification of adding a series of openings or “holes” in the ICL platform is therefore a complete game-changer in safety and effectiveness for patients wanting ICL surgery.

Am I a candidate for the ICL?

The EVO ICL is used to treat myopia and myopic astigmatism. It can be used to treat up to 20D of myopia and up to 4D of astigmatism. There are a few other factors we measure if someone is considering EVO ICL surgery, which is why the best way to learn if this surgery is right for you is to schedule a consultation with one of our eye doctors.

EVO ICL may be right for you if:

  • You are over the age of 18
  • You are interested in a vision correction solution for moderate to severe nearsightedness (with or without astigmatism)
  • Your prescription has not significantly changed within the last year
  • You have healthy eyes with the exception of being nearsighted or have astigmatism

Schedule a consultation at Parkhurst NuVision to find out today!

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Pre Operative Evaluation

The preoperative evaluation for EVO ICL is pretty straightforward. It involves measurement of the eye’s prescription, which is done a number of ways including “auto-refraction”, “manifest refraction”, “contact lens over-refraction”, and “cycloplegic refraction.” We also compare those measurements to the historical vision prescription that someone wears in their glasses and/or contact lenses. The second important preop evaluation criteria we look at includes the amount of space under the surface of the eye where the ICL will sit. This is known as measuring the “anterior chamber depth”. This can be done by anterior segment OCT, or ultra high resolution ultrasound biomicroscopy, which is the method we prefer. Performing ultra high DEF ultrasound biomicroscopy allows us to measure not just under the surface of the eye, but importantly we can measure shapes and structures that sit just behind the iris, or the colored part of the eye. This is important because sound waves can travel past the colored part of the iris in a way that light based scanners cannot. Using this type of pre-op scan technology has allowed us to develop the “Parkhurst Sizing Nomogram”, which has been shown to be the most accurate way to size ICL‘s in the published medical literature.

Power Calculation

Once we know the size of the ICL we are going to use, we also use the patient refraction, the central corneal power, overall eye health, and anterior chamber depth of the eye to select the power of lens needed. From our many years of experience, we have found the contact lens over-refraction to be one of the most important power calculations we do to ensure the best results. This and the Parkhurst sizing nomogram is part of what makes up part of our secret sauce, and is the reason why so many people fly to come and have EVO ICL surgery here in San Antonio, Texas.

What is the Difference between Visian ICL and EVO ICL?

EVO ICL is basically the same thing as the Visian ICL predecessor with the main difference being that more people qualify. It also has a few slight modifications in the lens making the prep steps simpler for people. Once you make the decision you’re ready to wake up and see without glasses and contacts, you can typically be back to your normal daily life within about 24-48 hours. So no major downtime or inconvenience for people with busy lives.

The first ICL was implanted in 1993 (the same time laser vision correction was beginning) worldwide
Over 1,000,000 ICLs have been implanted to date in over 60 countries
A new ICL is implanted worldwide every 6 minutes

Cost of EVO Visian ICL

Similar to LASIK eye surgery, the EVO ICL costs about $120/month with payment plans, which is how most people do it. The beauty is, compared to the ongoing cost of daily contacts, and thick, heavy, and/or expensive glasses, you get to stop throwing that money away once the procedure is paid off. EVO ICL typically pays for itself in ~4-5 years.

PRK
EVO ICL
SMILE
Long-Term Vision Outcomes
Excellent
Excellent
Excellent
Recovery Time
Few Weeks
24 hours
24 hours
Reversible
No
Yes
No
Procedure Duration for both eyes
10-15 minutes
10-15 minutes
10-15 minutes
Treats Nearsightedness
Yes up to -6D
Yes up to -20D
Yes up to -10D
Treats Extreme Prescriptions
No
Yes
No
Treats Astigmatism
Yes
Yes
Yes
Treats Farsigthedness
Yes
No
Yes
Good for patients with contact lens induced dry eye
Good
Best
Better
Can be used for Presbypopia
Yes
Yes
Yes

Surgical Technique: EVO ICL Surgery

Sound surgical technique for EVO ICL is a requirement for expert surgeons that are comfortable performing surgery in the front part of the eye. It involves prepping the eye and face with betadine antiseptic, numbing the surface of the eye with the use of anesthetic numbing eye drops, and providing the patient with a sedative (aka “happy meds”) to help ease any anxiety and make the patient comfortable. While the happy meds are working, the patient’s eyes will be dilated. The ICL procedure, which typically is done in about 7 minutes per eye, is done under pharmacological mydriasis, meaning that the eyes are dilated for the day of surgery. The patient is instructed to look straight ahead into the bright lights of the operating microscope, whereby the surgeon makes microscopic openings in order to effectively place the ICL under the surface of the eye. These openings are so tiny that they are self-sealing and do not require any stitches. The surgeon will prepare the EVO ICL in a microscopic injector cartridge which basically involves folding the EVO ICL into a tiny scroll, similar to a “taquito” like we often say here in South Texas. The scroll then unfolds and the surgeon places a protective gel under the surface of the eye as the foot plates of the EVO ICL are gently tucked into the sulcus of the eye behind the iris. All of this is performed in a simple painless procedure which generally takes less than seven minutes per eye. Once the EVO ICL is in the proper location, the protective gel is removed, and the eye is hydrated, and within minutes patients are able to sit up from the operating table and see their family members or the clock on the wall across the room.

Phakic Intraocular lens: EVO ICL Recovery

After the EVO ICL surgery, patients are typically able to see a major improvement within minutes of sitting up from the procedure. Waking up the next day and being able to just see is magical. Normally, there are one day, one week, and one month post operative visits. Steroid and antibiotic drops are usually prescribed for 1-4 weeks after surgery. Most patients will take off the day of the procedure, but can go back to work the next day. If you are flying in, we recommend staying in San Antonio for at least 24 hours before flying back.

Testimonial by Dr. Dan

Why Choose Parkhurst NuVision for ICL Surgery in San Antonio?

  • Dr. Parkhurst has also taught ICL surgery at the European Society of Cataract & Refractive Surgery, the International Society of Refractive Surgery, the Refractive Surgery Alliance, and the American-European College of Ophthalmic Surgeons.
  • Dr. Parkhurst was invited to Amsterdam in 2013 to be given an international award for being selected as the Visian ICL Surgeon of the Year.
Dr. Parkhurst presenting in Amsterdam

FAQs about the EVO Visan ICL

Q.
What are the success rates of EVO Visian ICL surgery in San Antonio?

The success rates of the Visian ICL family of lenses are incredibly high. Dr. Parkhurst has written textbooks and lectured all over the world about our results with the ICL, which in every study he has performed to date have equaled or exceeded those of LASIK. In a clinical trial Dr. Parkhurst performed and presented at the American Academy of Ophthalmology in 2010, 96% of eyes and 100% of patients saw 20/20 or better by 3 months after the procedure. In a clinical trial performed by Dr. Parkhurst and presented at the American Society of Cataract and Refractive Surgery, the ICL was found to result in better night vision and contrast sensitivity (determining different shades of gray) at statistically significant degrees more than LASIK.

Dr. Parkhurst was invited by the manufacturer of the ICL, STAAR Surgical, to present his published results to the US FDA, which helped achieve recommendations for approval of the toric ICL in the United States. Dr. Parkhurst’s results with the ICL are among the most cited and referenced research studies in the peer-reviewed, published medical literature

Q.
When was the first EVO ICL done in the US?

Dr. Greg Parkhurst of Parkhurst NuVision completed the first EVO Spherical ICL surgery on April 6, 2022, in San Antonio, Texas.

Q.
Will I be able to feel the EVO ICL in my eye?

No. The EVO ICL is placed under the surface of the eye where it cannot be seen or felt.

Q.
Does EVO ICL correct astigmatism?

Yes. Our team of surgeons is trained and has extensive experience performing the EVO Visian ICL, especially for patients with astigmatism. On November 1, 2018, Dr. Parkhurst performed the first Toric ICL procedure in the United States once the lens was FDA approved for widespread use. Learn more about Hope’s journey!

Q.
How long does the EVO ICL last?

The ICL is intended to stay in place and last indefinitely. The ICLs can last for the rest of your life. You have no need for glasses or contact lenses anymore and can live worry-free when it comes to your vision quality. And, EVO ICLs are completely reversible – Should the need arise, the EVO ICL can be removed or replaced. As long as you don’t develop any other unrelated eye issues, the ICLs can stay there permanently.

Q.
Who is the best EVO ICL surgeon in Texas?

There are very few surgeons in Texas who are both trained and experienced with the EVO ICL. Parkhurst NuVision is considered a top EVO ICL specialist in the United States and especially San Antonio; in fact, Dr. Parkhurst is recognized as a world subject-matter expert in this technology. He teaches and operates internationally. Surgeons have traveled to San Antonio from countries in Europe, Asia, and South America to learn from Dr. Parkhurst regarding techniques for optimal EVO ICL sizing, methods of astigmatism treatment, and best vision results.

Keys to Success with the EVO Lens podcast poster

Q.
How many ICLs does an experienced surgeon typically implant on a yearly basis?

Surgeon training and experience with EVO ICL matters. The majority of surgeons certified to implant ICL’s implant no more than 10 ICLs per year. Having a surgeon who understands the technology based on extensive experience, and performs hundreds of ICL procedures every year, is likely to result in the best outcomes and patient experience.

In October 2013, Dr. Parkhurst was given an award at an international ICL expert meeting in Amsterdam for passing the 1,000 ICL milestone. According to the manufacturer in 2016, Dr. Parkhurst is the only surgeon in the state of Texas, to have implanted over 1,000 ICLs.

Q.
When was the first toric EVO ICL done in the US?

The first Visian Toric ICL surgery after FDA approval was done at Parkhurst Nuvision on November 1, 2018. Dr. Lauren Libfraind and Dr. Scott Barnes performed the first EVO toric ICLs in the United States after FDA Approval of EVO Toric ICL on April 5 and 6, 2022.

Q.
Are EVO ICL’s ONLY for people that are not good candidates for LASIK and PRK?

Absolutely not! The FDA labeling for the ICL implant says nothing about non-candidacy for LASIK and PRK to be eligible for the ICL. Many doctors and patients see the extensive benefits of the ICL and select this instead of LASIK.

Q.
EVO ICL vs LASIK

The main difference between EVO ICL and LASIK is with LASIK a computer guided laser is used to reshape the conea to correct the imperfections in someones focusing ability. The EVO ICL corrects vision with a thin, permanent biocompatible lens placed under the surface of the eye by a surgeon.

When it comes to the choice between EVO ICL vs. LASIK, it ultimately depends on the patient’s needs. There are numerous differences between these two procedures. LASIK is a procedure that can correct myopia, hyperopia, or astigmatism by reshaping the cornea using a laser. EVO ICL works for myopia and astigmatism. It is like having permanent vision correction that never need to be taken out, cleaned, or maintained, so the cornea’s shape is not changed. More types of vision problems can be corrected with LASIK, but people who have thin corneas or chronic dry eye, or just want a reversible solution for peace of mind may choose EVO ICLs.

Q.
Austin ICL and Laredo ICL

Our San Antonio surgery center, serves patients in San Antonio, New Braunfels, Austin, Laredo, Dallas, Houston and other Texas communities, featuring a world subject-matter expert in this technology. At Parkhurst NuVision, we know your eyes and vision are as unique as your fingerprint. We give people in San Antonio, Texas, and those who travel to see us from all over the world the largest range of eye procedures so you can get the vision procedure that is right for you. Whether that be LASIK, PRK, SMILE-LASIK, or procedures to fix near vision after age 40, Parkhurst NuVision is here to help with a long-term solution. If you are flying in from another location, feel free to contact us so we can walk you through our destination ICL surgery process. We won’t let you miss out on the best places to eat and attractions to visit while we help you obtain your nuvision.

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1Parkhurst G, Psolka M, Kezirian G. Phakic intraocular lens implantation in United States military warfighters: A retrospective analysis of early clinical outcomes of the Visian ICL. J Refract Surg. 2011;27(7):473-481
2 Igarashi A, Kamiya K, Shimizu K, Komatsu M. Visual Performance after implantable Collamer lens implantation and wavefront-guided laser in situ keratomileusis for high myopia. Am J Opthalmol. 2009.
3Martinez-Plazs E, Lopez-Miguel A, Lopez-De La Rosa A, et al. Effect of the EVO+ Visian Phakic Implantable Collamer Lens on Visual Performance and Quality of Vision and Life, Am J Ophthalmol 2021;226: 117–125.
4Ganesh S, Brar S, Pawar A. Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism. Clin Ophthalmol. 2017 Jul 3;11:1253-1263.