Ocular Evidence
Procedures / ICL
Phakic intraocular lens

ICL outcomes

An artificial collamer lens is implanted behind the iris and in front of the natural crystalline lens; the natural lens is not replaced.

Source: U.S. Food and Drug Administration — P030016/S035
Find overlapping cohorts
9studies represented
11study arms
19,274reported enrolled eyes*
8 yearslongest standardized follow-up

* Descriptive sum of reported arm counts. Missing eye counts are not treated as zero, and overlapping cohorts may not be additive.

How the operation changes the eye
Three-stage medical illustration showing an ICL inserted, unfolded, and positioned behind the iris in front of the natural lens
Original explanatory illustration. Simplified anatomy; exact devices and technique vary.
How the operation works

An additional lens is placed inside the eye

ICL corrects focus by adding a lens while leaving the eye’s natural lens in place.

  1. The surgeon makes a small opening at the edge of the cornea.
  2. A folded implantable lens is inserted and unfolded inside the eye.
  3. The lens is positioned behind the iris and in front of the natural lens.
Clinical reference: Moorfields Eye Hospital — implantable contact lenses

Study-specific outcomes

Percentages are displayed individually. They are not pooled or averaged.

LOW evidenceRETROSPECTIVEVerified evidence

Comparison of Persistent Postoperative Discomfort 1 Year after Keratorefractive Lenticule Extraction and Implantable Collamer Lens Implantation (2025)

EVO Visian ICL V4c implantation97 enrolled eyesEVO Implantable Collamer Lens
1 year97 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
Postoperative night glare
Postoperative halos
HIGH evidenceFDA POST APPROVALVerified evidence

Three Year Results from the United States FDA Prospective Multicenter Clinical Study of the EVO/EVO+ Implantable Collamer Lens (2025)

EVO/EVO+ ICL629 enrolled eyesEVO Implantable Collamer Lens
3 years629 eyes observed
Not reportedUncorrected 20/20 or better
90.7%
629 eyes
Source
Refraction within ±0.50 D
99.0%
629 eyes
Source
Refraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-0.12 DSource
Mean postoperative spherical equivalent
48.9%
629 eyes
Source
Gained 1 or more lines of corrected visual acuity
0.32%
2/629 eyes
Source
Lens exchange rate
0.16%
1/629 eyes
Source
Anterior subcapsular cataract rate
LOW evidenceRETROSPECTIVEVerified evidence

One-Stage Versus Two-Stage Bilateral Implantable Collamer Lens Implantation: A Comparison of Efficacy and Safety (2024)

Same-day bilateral ICL100 enrolled eyesDevice not reported
Mean 1.1 years100 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
Post-ICL endophthalmitis
LOW evidenceRETROSPECTIVEVerified evidence

One-Stage Versus Two-Stage Bilateral Implantable Collamer Lens Implantation: A Comparison of Efficacy and Safety (2024)

Staged bilateral ICL78 enrolled eyesDevice not reported
Mean 1.3 years78 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
Post-ICL endophthalmitis
MODERATE evidencePROSPECTIVE COHORTVerified evidence

Two-Year Visual Outcomes of Evolution Implantable Collamer Lens and Small Incision Lenticule Extraction for the Correction of Low Myopia (2022)

EVO ICL25 enrolled eyesEVO Implantable Collamer Lens
2 years25 eyes observed
Not reportedUncorrected 20/20 or better
96.0%
24/25 eyes
Source
Refraction within ±0.50 D
Not reportedRefraction within ±1.00 D
0%
0/25 eyes
Source
Lost at least 2 lines of CDVA
Additional source-reported outcomes
80.0%
20/25 eyes
Source
Uncorrected acuity at least as good as preoperative corrected acuity
MODERATE evidenceRETROSPECTIVEVerified evidence

Eight-Year Outcomes of Implantation of Posterior Chamber Phakic Intraocular Lens With a Central Port for Moderate to High Ametropia (2021)

EVO ICL177 enrolled eyesEVO Implantable Collamer Lens
8 years177 eyes observed
Not reportedUncorrected 20/20 or better
83.0%
177 eyes
Source
Refraction within ±0.50 D
93.0%
177 eyes
Source
Refraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
1.7%
3/177 eyes
Source
Cataract requiring lens extraction or exchange
Efficacy index
Safety index
MODERATE evidencePROSPECTIVE COHORTVerified evidence

Five-year outcomes of EVO implantable collamer lens implantation for the correction of high myopia and super high myopia (2021)

High myopiaEye count not reportedEVO Implantable Collamer Lens
5 yearsFollow-up sample not reported
Not reportedUncorrected 20/20 or better
60.5%Source
Refraction within ±0.50 D
79.1%Source
Refraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-0.67 DSource
Mean postoperative spherical equivalent
Efficacy index
Safety index
MODERATE evidencePROSPECTIVE COHORTVerified evidence

Five-year outcomes of EVO implantable collamer lens implantation for the correction of high myopia and super high myopia (2021)

Super high myopiaEye count not reportedEVO Implantable Collamer Lens
5 yearsFollow-up sample not reported
Not reportedUncorrected 20/20 or better
22.5%Source
Refraction within ±0.50 D
47.5%Source
Refraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-1.74 DSource
Mean postoperative spherical equivalent
Efficacy index
Safety index
LOW evidenceRETROSPECTIVEVerified evidence

Visual Outcomes, Footplate Position and Vault Achieved with the Visian Implantable Collamer Lens for Myopic Astigmatism (2021)

EVO/EVO+ ICL42 enrolled eyesEVO Implantable Collamer Lens
3 monthsFollow-up sample not reported
Uncorrected 20/20 or better
Refraction within ±0.50 D
Refraction within ±1.00 D
Lost at least 2 lines of CDVA
LOW evidenceRETROSPECTIVEVerified evidence

Endophthalmitis Rates After Implantation of the Intraocular Collamer Lens: Survey of Users Between 1998 and 2006 (2009)

Responding surgeons' ICL implantations17,954 enrolled eyesDevice not reported
Survey period; per-eye follow-up not standardized17954 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
0.017%
3/17954 eyes
Source · Abstract
Post-ICL endophthalmitis