Key Takeaways

  • Staar Surgical's global analysis found declining or stagnant laser procedure volumes alongside increasing adoption of phakic IOLs across multiple refractive surgery markets
  • Patient attitudes may be contributing to the trend, with 59% of surveyed consumers reporting they were not open to laser correction and 58% expressing interest in a reversible option
  • Asian markets currently lead phakic IOL adoption, while lower awareness in the United States and Europe may leave room for further growth in implantable lens correction

Staar Surgical has released a global market analysis suggesting refractive surgery is undergoing a gradual shift from laser-based procedures toward implantable lens correction, with changing patient preferences and evolving clinical practice patterns contributing to increased adoption of phakic IOLs.

The report, The Future of Refractive Surgery, examines patient sentiment, procedure trends and clinical practice patterns across Japan, China, South Korea, the United States, Germany, Spain, and the UK and Ireland. The analysis incorporates a consumer survey of 7,800 respondents as well as data from academic research.1

According to Staar, the findings point to a consistent increase in implantable lens correction across multiple markets, including regions where awareness of ICL technology remains relatively low. The company, which manufactures the Evo family of Implantable Collamer Lenses (Evo ICL), is presenting the report as evidence of structural changes affecting both patient demand and refractive surgery practice.

The report found that excimer laser procedure volumes have declined or remained stagnant across the geographic regions examined, while phakic IOL adoption has increased.

The US market showed one of the largest divergences. According to the report, US laser procedure volume has declined 52% since 2022, representing 4 consecutive years of double-digit decreases. During the same period, adoption of Evo ICL increased 76%, which Staar said has more than tripled the technology's market share. Patient attitudes may provide an indication of how the refractive market will develop, according to the analysis.

Among consumers surveyed globally, 80% said they would like to be free from glasses and contact lenses, while 58% said they were attracted to a vision-correction option that is reversible. The survey also found that 59% of respondents were not open to laser vision correction.

Safety concerns and fear of the procedure were each identified by 38% of respondents as barriers to laser correction, compared with 32% who cited cost.

Japan offers a view of a lens-based refractive market

Staar highlighted Japan as the most developed market for lens-based vision correction among those included in the report. ICL procedures now account for more than half of refractive procedures in the country, according to the analysis.

Consumer awareness also differs from that observed in Western markets. In Japan, 46% of respondents demonstrated unaided awareness of ICL, compared with 40% for LASIK.

Awareness of implantable lens correction remains substantially lower in several markets that Staar identified as being at an earlier stage of the same transition. Awareness was reported at 18.9% in Germany, 19.3% in the United States, 20% in the UK and Ireland, and 27% in Spain.

The company said changes in how patients research refractive procedures may contribute to future adoption patterns. Patients increasingly obtain information through search engines, social media, online communities and artificial intelligence tools in addition to consultations with eye care professionals.

In the United States, 53.5% of surveyed consumers said they would use search engines to investigate vision correction, and 25.5% said they would use AI tools such as ChatGPT.

Changes in surgeon practice appear to be occurring alongside shifts in patient sentiment.

Staar cited an AECOS study involving 1,882 eyes treated at 19 US practices in which ICL implantation accounted for 72% of refractive procedures performed in patients with myopia of -8.0 D or greater.2

The company suggested that expanding surgeon training and familiarity with phakic IOL implantation could further increase consideration of lens-based correction for appropriate patients.

Long-term demographic trends may also expand the potential patient population. Global prevalence of high myopia, defined in the report as -6.0 D or greater, is projected to approach 1 billion people by 2050, with particularly large populations in East and Southeast Asia.3 According to the report, phakic IOLs have more than quadrupled their share of global refractive procedures during the past decade while laser procedure volumes have remained broadly flat.

Staar representatives will discuss the report during the 44th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), scheduled for September 11 to 15, 2026, in London.

References

  1. STAAR Surgical Consumer Survey, Global Combined Summary (n=7,800). Fieldwork: March 2025 (UK), August 2025 (US), March 2026 (Germany, Spain), May 2026 (China, Japan, South Korea).
  2. AECOS US Refractive Surgery Study Data 2024, n=1,882 procedures, Internal Data on File.
  3. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016