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
11studies represented
14study arms
19,315reported 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.

MODERATE evidenceRETROSPECTIVEVerified evidence

Toric versus Standard Implantable Collamer Lens Implantation for Low Myopic Astigmatism: A 12-Month Retrospective Study (2026)

Toric ICLEye count not reportedDevice not reported
12 monthsFollow-up sample not reported
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
-0.080 logMARSource · Abstract
Mean uncorrected distance acuity
Mean residual refractive cylinder
MODERATE evidenceRETROSPECTIVEVerified evidence

Toric versus Standard Implantable Collamer Lens Implantation for Low Myopic Astigmatism: A 12-Month Retrospective Study (2026)

Standard ICLEye count not reportedDevice not reported
12 monthsFollow-up sample not reported
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
-0.030 logMARSource · Abstract
Mean uncorrected distance acuity
Mean residual refractive cylinder
LOW evidenceRETROSPECTIVEVerified evidence

Long-term Efficacy and Safety of the Implantable Collamer Lens in Eyes With an Anterior Chamber Depth of 2.6 to 2.8 mm (2026)

ICL V4c in shallow anterior chambers41 enrolled eyesEVO Implantable Collamer Lens
Final visit: 6–10 years (mean 7.76 years)41 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
0.150 logMAR
41 eyes
Source · Table 1
Mean uncorrected distance acuity
Loss of corrected distance acuity (any lines)
Mean endothelial cell density decrease
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