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EVO / EVO+ Candidacy

WHEN LASER SAYS NO, SHOW THE NEXT BEST OPTION.

Written by the RLES AI clinical rules team · Medically reviewed by Ercüment Bozkurt, MD · Fırat Helvacıoğlu, MD · Last updated: 21 August 2026

A high correction, a flat cornea or a thin stroma can eliminate laser surgery while the eye remains perfectly treatable. RLES AI evaluates STAAR EVO/EVO+ candidacy automatically whenever laser is eliminated — so the consultation ends with a plan, not a refusal.

THE ACD TRAP THAT FLIPS ELIGIBILITY DECISIONS

The anterior chamber depth criterion is defined from the endothelium — but devices disagree: an IOLMaster measures from the epithelium and reads roughly 0.5 mm deeper than a Pentacam’s internal ACD on the same eye.[2] That half millimetre is more than twice the gap between the 2.8 and 3.0 mm thresholds: an ineligible eye can look eligible purely because of the measurement plane. RLES AI records which plane was measured, converts epithelial readings using pachymetry, and refuses to guess when the conversion cannot be made.

FULL INDICATION SCREEN, CLEARLY REASONED

  • Myopia −0.5 to −20.0 D with cylinder up to 6.0 D; hyperopia (CE region) +0.5 to +16.0 D — regional labelling differences stated explicitly
  • Age window, endothelial cell density against the age-indexed minimum, anterior chamber angle context
  • Screening, not sizing: white-to-white, sulcus morphology and vault prediction remain the implanting surgeon’s domain, and the report says so

ONE DOCUMENT, READY FOR REFERRAL

The output is a signature-ready screening report: why laser was eliminated (with the exact floor that failed), why the eye is or is not an ICL candidate, and the data the implanting surgeon will need. A tissue-eliminated patient leaves with a pathway.

FREQUENTLY ASKED QUESTIONS

When does RLES AI point to a phakic ICL?
When the tissue is sufficient but the optics are not — corrections beyond the safe post-operative keratometry window, or corneas excluded by the safety floors — the EVO/EVO+ screening pathway opens.
Why is the ACD measurement plane critical?
The FDA threshold is measured from the endothelium. A device that measures from the epithelium reads about 0.5 mm high — more than twice the margin between eligible and ineligible. RLES AI converts and reports the true ACD.
SEE IT ON YOUR OWN CASES.
RLES AI runs as a mobile interface on your phone — nothing to install from a store, reports in minutes. The final clinical decision always rests with the surgeon.

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References — peer-reviewed sources
  1. Reinstein DZ, Vida RS, Archer TJ. Visual Outcomes, Footplate Position and Vault Achieved with the Visian Implantable Collamer Lens for Myopic Astigmatism. Clin Ophthalmol. 2021;15:4485-4497. doi:10.2147/OPTH.S330879 PMID: 34848942
  2. Nakakura S, Mori E, Nagatomi N, Tabuchi H, Kiuchi Y. Comparison of anterior chamber depth measurements by 3-dimensional optical coherence tomography, partial coherence interferometry biometry, Scheimpflug rotating camera imaging, and ultrasound biomicroscopy. J Cataract Refract Surg. 2012;38(7):1207-13. doi:10.1016/j.jcrs.2012.02.036 PMID: 22613688
Sources open on PubMed in a new tab.