The little hole is only 360 microns (.36 mm) in diameter but it makes a world of difference for safety and visual quality. The little hole is the small central port placed in the middle of an ICL (Implantable Collamer Lens) from STAAR Surgical. This lens implant is called the EVO. The small hole eliminates the need to make an opening in the colored part of the eye (the iris). During implantation of the original ICL, an opening in the colored part of the eye (known as an iridotomy/iridectomy) was needed to prevent a type of glaucoma. Creating the opening during surgery in the iris could cause initial bleeding in some cases and, for some patients, could lead to visual distortions from the light passing through that opening. With the EVO lens, this is no longer the case. Over 1 million EVO lenses have been implanted outside the US prior to the recent FDA approval of the EVO lens in the US. An added feature is that it appears to be more physiologic having the fluid that is made behind the iris come through this middle hole instead of one made in the peripheral part of the iris. This appears safer for both the cornea (the window of the eye) and the natural crystalline lens. The development of cataracts is less likely to occur earlier than normal in eyes with EVO lenses based on what doctors tell me from outside the US. We are excited to be one of the first practices offering the EVO Visian ICL in the US. The EVO is easily removed later in life when cataracts naturally occur, and the EVO does not make changes to the corneal surface or increase the risk of dry eye symptoms. It is a great breakthrough.
THIS LITTLE HOLE by Dr. Francis Price
Why is this little hole such a big deal?
THE LATEST NEWS FROM PRICE VISION GROUP
Join the EVO USA Study
Break free from Glasses & Contact Lenses
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If you suffer from nearsightedness or astigmatism, EVO may improve your distance vision without glasses or contact lenses. Your eyeglass prescription can usually tell you how much nearsightedness and/or astigmatism you have. Consult with your eye doctor, who will conduct a thorough examination to find out whether you’re a candidate for the EVO USA Study and the EVO procedure.
It’s time to experience the EVO difference
The EVO procedure is designed to improve sight by treating a wide range of eyeglass or contact lens prescriptions. Made from Collamer®, a unique implantable material, the replaceable lens works naturally with your eye to improve vision-without changing your cornea. As a result, over 1 million lenses have been implanted outside of the US and 99.4% of patients would do the procedure again.
How EVO Works
The EVO biocompatible lens is placed behind your iris (colored part of your eye) and in front of the natural lens. The EVO lens focuses light on the back surface of your eye to improve your vision. Unlike other procedures, the EVO procedure does not remove corneal tissue, but is additive, and works in harmony with your natural eye.
Join the EVO USA Study
To learn more about this study, and to see if you qualify, please call (317) 814-2820 and ask to speak with Sam Ven. If you are eligible and participate in this research study, you will be asked to return for examinations to evaluate your vision.
Sam Ven
(317) 814-2820
Price Vision Group
9002 N. Meridian Street
Suite 106
Indianapolis, IN 46260
Pioneering cornea surgeon Francis W. Price, Jr., MD of Price Vision Group in Indianapolis, IN is scheduled to become the first in the U.S. to perform the revolutionary LIKE procedure. LIKE (LASIK and Intrastromal Keratoplasty) is the next generation in refractive surgery to correct extreme farsightedness in people who cannot be helped by current LASIK or refractive techniques.
Clear, focused vision depends on the cornea and lens, which refract, or bend, incoming light, projecting it precisely on the retina, which sends visual information to the brain. Farsightedness, or hyperopia, is a condition where the eyeball is too short, causing images to project past the retina and affects about 10-20% of the population in the U.S. This makes up-close objects appear extremely out of focus, while far away objects are less out of focus but still not clear. Glasses or contact lenses are the most common treatments. Surgical options have been limited, especially for those with high degrees of farsightedness, because there is no procedure to extend the length of the eye.
Refractive procedures, such as LASIK, have been successful in treating low levels of farsightedness. Currently, higher levels of farsightedness can only be treated with corrective eyewear, cataract surgery, or in patients without cataracts, with a refractive lens exchange where the natural lens in the eye is replaced with an artificial lens (IOL). These options work well for those in their 40’s or older, but cause younger people, who still have the ability to focus up close, or accommodate, to lose that ability. There is also more risk with having surgery inside the eye, rather than on the surface as with LASIK.
What is LIKE? (LASIK and Intrastromal Keratoplasty)
LASIK and Intrastromal Keratoplasty, or LIKE, offers a cutting-edge surgical treatment for those with farsightedness starting at 3 diopters and up to 10 diopters, a level which has been previously untreatable with LASIK.
LIKE is a two-part procedure which places a portion of a donor cornea into the stromal, or structural, layer of the cornea and upon healing, LASIK is performed. The insertion of the structural donor layer alters the shape of the cornea so that light and images are precisely focused on the retina resulting in excellent, clear vision. This procedure has similarities to a standard LASIK procedure where a flap is created and then lifted to begin treatment. Unlike LASIK, instead of using an excimer laser to remove tissue (ablation), a donor cornea is implanted (to add tissue). After the vision has stabilized, (~2-3 months), the LASIK treatment will be performed on the donor tissue (not the patient’s tissue) to fine tune the vision.
Dr. Francis Price, Jr., who is a world-renowned surgeon and founder of the Cornea Research Foundation of America, has trained more than 600 eye surgeons on advanced surgical techniques, and routinely cares for the most complex eye conditions in patients from around the world. He, along with other Price Vision Group surgeons, have helped pioneer and perform more cornea transplants and specialized procedures than any other clinic in North America. As a result of his excellent track record in pioneering surgical treatments, he was chosen to become the first in the U.S. to perform this ground-breaking new technique.
Terms:
Stroma – the structural part of the cornea, the window of the eye
Keratoplasty – cornea transplant, placing a donated cornea from another person into some one’s cornea
Indianapolis, IN, November 8, 2018 – Price Vision Group is the first practice in Indiana to implant the new FDA-approved Visian Toric ICL from STAAR Surgical. This new implantable collamer lens (ICL) provides a new solution for patients with moderate to high levels of myopia and astigmatism ‒ in one simple procedure. Previously, ICL patients with astigmatism would need a separate LASIK procedure to correct astigmatism.
Matt, a resident from Lafayette, will become the first patient in Indiana to receive the Visian Toric ICL. “I’ve been in glasses since kindergarten and hard contacts since fifth grade… so I’m excited,” stated Matt just before his surgery. The procedure to insert the Visian Toric ICL takes about 20-30 minutes and consists of placing the ICL between the iris (the colored part of the eye) and the eye’s natural, crystalline lens to correct vision. For patients with high levels of nearsightedness, an improvement in vision should be noticed almost immediately after the procedure.
As one of the most experienced Visian ICL surgeons in the country, Dr. Francis Price is happy to provide another option for patients looking to be free from glasses or contacts. When asked what he’s looking forward to most after his surgery, Matt replied, “Waking up to see the alarm clock every morning.”
On September 13, 2018, STAAR Surgical announced the approval by the FDA of the Visian Toric ICL (TICL) for the correction of myopia with astigmatism. Before the announcement, the Visian ICL (implantable collamer lens) product line in the United States only consisted of lenses that offer correction for patients with myopia (nearsightedness). Visian ICL patients with astigmatism would require an additional LASIK procedure to correct that refractive error. Price Vision Group has been performing procedures with the standard Visian ICL since 2004. This announcement is incredible news for our patients with high myopia and astigmatism who were not candidates for LASIK or PRK. “FDA’s approval of STAAR’s Visian Toric ICL in the U.S. provides an exciting treatment option for myopic patients with astigmatism in search of visual freedom. We are thrilled to be able to offer this lens in the United States and look forward to officially making the Visian Toric ICL available to U.S. surgeons for their patients on November 1st, 2018,” said Caren Mason, President & CEO. Offering our patients the best vision correction options is our top priority and we will update our patients on the availability of the Visian Toric ICL when we receive them. To learn more about the Visian ICL and to see if it’s right for you, please click here. *Update* The Visian Toric ICL is now available and we’re proud to be the first clinic in Indiana to implant the ICL.
Yes! The Visian ICL can often help those who are very nearsighted as a result of keratoconus. For young people with keratoconus, we often recommend corneal cross-linking to make sure the cornea becomes stable and the keratoconus does not progress. In many cases, we place small reinforcing rings in the cornea called either intracorneal ring segments or Intacs. The plastic ring segments help stabilize the distorted surface of the cornea to improve vision and decrease astigmatism. Once all is stable, we can use a Visian ICL to correct the leftover nearsightedness or myopia. We are lucky to live at a time when we have a number of options to treat keratoconus such as corneal cross-linking, intracorneal ring segments (Intacs), and the Visian ICL.
The UBM is an ultrasound that allows the doctor to see inside the eye, behind the iris (the colored part of the eye). Just like an ultrasound allows doctors to see inside our bodies for things like evaluating a pregnant woman to make sure a baby is OK, these ultrasounds allow us to look into an eye and make sure there are no abnormalities in the area of the eye where the Visian ICL is placed. It also allows us to accurately measure the space where the Visian ICL is positioned so the correct size can be determined. In my opinion, this has been more accurate than just measuring the width of the cornea. The width of the cornea is variable depending on how the white part of the eye and the cornea developed, or if there has been scarring from contact lens wear, infections, or other inflammatory problems on the surface of the eye. Although it takes a little longer to do the UBM measurements, I feel that it has greatly improved the outcomes with Visian ICL surgery.
Soft contact lenses have an inherent problem with trying to correct astigmatism.
The problem is that with each blink, contact lenses not only move up and down, they
also rotate either clockwise or counter clockwise. The rotation does not matter if
the correction is only spherical (meaning nearsighted or far sighted corrections).
However with astigmatism, the curvature of the corneal surface and the curvature of
the contact lens each vary in different directions (like the shape of an American
football). When the lens is in perfect position, everything is great, but then we have
to blink and the lens rotates a few degrees, and with the next blink a few more
degrees. Suddenly the soft contact lens is no longer correcting the disparity in
curvature, in fact when it rotates 90 degrees it actually makes the astigmatism twice
as bad as it was before!! In order to compensate for this rotational movement, soft contact lenses for
astigmatism are frequently made with ballasts or prisms so that when an eye blinks
and the lens rotates, the ballasts or prisms cause the lens to rotate back. This helps,
but many patients find this disorienting – especially as the two eyes rotate the
lenses in opposite directions. All contact lenses have to move up and down a little
with each blink to keep tears moving in and out from under the lens. So with each
blink the vision is made a little blurry with contact lenses, even spherical ones. But
with astigmatism we also get rotational disorientation typically different for the two
eyes. This is why many people don’t even have their astigmatism corrected at all
with their soft contact lenses. Lasik is far superior to soft contact lenses in correcting
astigmatism because the correction is applied directly on the surface of the eye.
The correction does not move with each blink; instead, it is stable in any direction of gaze.
A: The Visian ICL, like all lens implants for nearsightedness, gives excellent visual
results. Some doctors have even referred to the outstanding visual results with the
Visian ICL as High Definition Vision – because it is so clear and predictably good.
One of the advantages of the Visian ICL for those who are very nearsighted is
that images will appear larger than with glasses. For someone who has a
prescription of -10.00 diopters, images will be 20% larger. In fact, for every diopter
of myopia (nearsightedness) corrected, there is a 2% increase in image size.
Glasses, in effect, make everything smaller if you are nearsighted – like looking
through a pair of binoculars the wrong way! The Visian ICL basically restores one’s
visual image to the size it should be normally.
A: Lasik is a great surgery; I have been doing it for over 20 years. Lasik is very
effective for treating astigmatism, nearsightedness, and farsightedness. However, in
some cases, Lasik may not be the best treatment or even advisable for some people.
The Visian ICL by Staar Surgical is an excellent option for those who are nearsighted and cannot have Lasik.
Visian ICLs work well for many people who have thick nearsighted glasses
often too much for Lasik corrections. Personally, I prefer the Visian ICL for
prescriptions greater than -8.00 diopters, and for many greater than -7.00 diopters.
In some cases with lower prescriptions, the Visian ICL may also be recommended if
someone’s cornea is too thin or there are signs of condition like keratoconus or a
tendency towards keratoconus.
