EVO was approved by the US FDA in March 2022. In just a little more than 1 year, the availability of this lens has had a significant impact on our business model and the way that we position the procedure to patients—as a premium option. This shift happened years ago in other countries, where EVO has been available for more than 10 years. But for those of us practicing in the United States, we can now truly offer ICL surgery for a wider range of patients. Growing your practice with ICL surgery has therefore gotten easier because surgery is streamlined, and postoperative results are proven to be safe and effective (see “What You Can Expect With Patient Outcomes,” pg 6).1
EVO CANDIDATES
IQ Laser Vision has 14 locations, six of which are equipped for surgery. We offer both laser and lens-based solutions for refractive correction because we believe that offering a multitude of procedures is the best approach to ensure patient satisfaction and increase word-of-mouth referrals. Once you know a certain procedure is best for your patient, it becomes easy to talk about with them. Comfort in recommending EVO therefore starts with a fundamental belief that the procedure is in the best interest of your patients.
The optometrists in our practice are really the gatekeepers to our patients. They meet with patients first and assess if they are a good candidate for refractive surgery in general and laser or lens-based surgery specifically. We do not work heavily with comanaging optometrists, but we have seen an increase in referrals after EVO was approved for use in the United States.
Since introducing EVO in our practice, I have increased confidence in the ICL technology for several reasons.
- No. 1. It is no longer a two-step process where a preoperative peripheral iridotomy is needed.
- No. 2. There is a lower risk of pupillary block and anterior subcapsular cataract.1
- No. 3. According to a review of my own data, fewer than 1% of eyes have elevated IOP (>25 mm Hg) postoperatively.
As I became more comfortable with the results, I started expanding my EVO candidates and usage and suggesting EVO for appropriate patients who are in the lower diopter range of myopia. I now find that eligibility for EVO extends to patients with lower amounts of myopia, those with a calculated residual stromal bed thickness of less than 280 µm, and those who may be at risk for keratoconus.
POSITIONING AND PROMOTING EVO
Your approach to positioning EVO will depend on your practice. For a practice like mine, which is focused on refractive surgery, the key is to portray confidence in the procedure. I first started offering the Visian ICL version 4 to patients with troublesome corneas or high myopia (>-10.00 D). When EVO was approved this past year, I began offering EVO for patients with a normal cornea and greater than -7.00 D of myopia. As more patients at our practice elected to have EVO, their friends, family, and coworkers began asking for EVO. Based on their eye condition, occupation, and visual goals, we are offering EVO to patients with as low as -3.00 D of myopia. Results of the US FDA clinical trial confirm that EVO is accurate, predictable, and stable for the correction of moderate myopia and myopic astigmatism.1
Happy patients present a great opportunity to share EVO results on social media. I treated a patient who had -20.00 D of myopia and 2.00 D of astigmatism. Right off the table after EVO surgery, she was crying because she could see clearly. Her mom was crying, too. We captured the moment and posted it to social media (with the patient’s permission). It was a powerful testimonial for the procedure and for our practice.
An even more powerful testimonial is for patients to share their experience on their own social media accounts. Everybody has a unique sphere of influence, and we have found this is an extremely helpful way to grow our business.
BUILDING MOMENTUM
STAAR Surgical has done an excellent job building momentum behind EVO. Recently, three celebrities—Joe Jonas, of the Jonas Brothers band, Max Strus, who plays for the NBA’s Miami Heat, and actress Peyton List—have undergone the EVO procedure. Some patients now come in asking for EVO because they saw the campaign with Joe Jonas. It’s a very effective way to help raise awareness of the procedure among the general public.
Another helpful way we build momentum in the community is to educate our colleagues, specifically the optometry community. When optometrists are exposed to the procedure and understand the benefits and potential outcomes, they are more prepared to talk to patients about what the procedure can do for them. Over time, that builds awareness of the procedure.
Lastly, we have found it important to share successes with our staff, so they know how great the procedure is. It helps them be more authentic and enthusiastic when they talk to patients about EVO. Our counselors love to be involved when we do EVO, especially for patients with higher prescriptions or have been told they aren’t candidates for laser refractive surgery because they are so ecstatic after surgery.
THE POWER OF WORD-OF-MOUTH REFERRALS
One of the strongest practice builders is word-of-mouth referrals. Once you start offering EVO, more patients will be talking about it in the community. If they’ve had a great experience with the technology and with your center, they will refer their family and friends. This can have a snowball effect over time.
The single most important thing we’ve done is to get the word out in our community via social media and our website. We now have people coming in asking for EVO whereas in the past they would be asking for LASIK. We also have more patients who were told at another center that they were a good candidate for EVO coming in for a second opinion. In our experience, we confirm that EVO is the best choice for them, and they’ve had surgery at our center. Maybe they didn’t have surgery with the first doctor because it might have been the first time they’d heard about EVO. As more and more surgeons offer the procedure, patients will feel more comfortable with it as a premium refractive solution.
1. Packer M. The EVO ICL for moderate myopia: results from the US FDA clinical trial. Clin Ophthalmol. 2022;16:3981-3991.
