Q&A: Eva Kim, MD, on the value of EVO ICL for patients considering surgery

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This year, the American Society of Cataract and Refractive Surgery (ASCRS) holds its annual meeting in Los Angeles, California. On the first day of the meeting, the Eye Care Network spoke with Eva Kim, MD, an ophthalmologist and refractive specialist from Denver, Colorado. She spoke about the EVO implantable collamer lens (ICL), a reversible intervention for patients with high myopia. According to Dr. Kim, these ICLs have a number of qualities which make them appealing to younger patients with high myopia

Note: This conversation has been lightly edited for clarity.

Ophthalmology Times: What are the advantages of using the EVO ICL for patients with low to moderate myopia?

Eva Kim, MD: The key advantages of using EVO ICL in low to moderate myops, with comparison to more traditional corneal refractive surgery, is its reversibility, and honestly it's also, to the patient, feels extremely non-invasive. Our patients in the age group that are getting EVO ICL, frankly, like anyone actually, are feeling afraid to commit to a specific type of surgery. So when I describe EVO ICL surgery as an additive procedure where I'm adding a custom contact lens into their eye to give them amazing vision, and at any point, if they want it reversed, I can remove that ICL, and their eye will be exactly as it was before. I think that's extremely attractive to our patients. So if we have a patient who is a great candidate for LASIK and a great candidate for EVO ICL in our clinic, we present them as both excellent options. We don't present ICL surgery as a, you know, secondary option. We really present them as as equals. When we give the advantage of that reversibility with the EVO ICL, over 50% of our patients are, frankly, choosing the EVO ICL.

OT: How does the EVO ICL design contribute to its safety profile?

Kim: The EVO ICL design definitely contributes to its safety profile, and I think that is why so many more surgeons are now deciding that they would like to understand how to do this surgery, and it really has to do with the EVO ICL does not require a pre-operative laser, peripheral iridotomy. You know, we've all had to do that type of laser for glaucoma, etc, and it's probably one of our most invasive, potentially painful, potentially bloody procedures that we do in the clinic. Patients can feel it. There can be blood in the anterior chamber, inflammation, pressure spikes, and it's just- it feels very intense for patients. So I think that was a definite barrier with the previous model, ICL. Now with EVO ICL, we no longer need to do the pre-operative laser peripheral iridotomy. It shortens the process for our patients, and it's just so much easier that they don't have to go through that laser.

OT: In your experience, how are patients receiving the visual outcomes and the recovery following EVO ICL?

Kim: So in the post-op period, patients will often ask me, you know, what is my healing going to be like, especially compared to LASIK, because they are familiar with their friends who have had LASIK. They know it's about a one day to one week recovery when it comes to vision and comfort, but they also know that they have friends that have had some dry eye issues. I will explain EVO ICL post operative period as being similar in the timing perspective, so blurry on the first day of surgery. The next morning, when they wake wake up, is really going to be that AH-HA moment where they realize that their vision is amazing. Frankly, they they're more comfortable through their healing process. Day of surgery, they have to deal with vision that is blurry because of dilation, but otherwise their acuity is quite good, just having some glare from the dilated pupil. But as far as comfort goes, there's very little, if any, pain. It's more of a dry eye feeling at most and patients feel like it's an easy, easy recovery. So timing wise, similar to LASIK, comfort wise, I think improved to LASIK.