# EDGAR Filing Document

**Accession Number:** 0001325697
**File Stem:** 0001325697-26-000006
**Filing Date:** 2026-5
**Character Count:** 8573
**Document Hash:** bc6ab4d8e58afe8bd1c5dfc23e0910c0
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001325697-26-000006.hdr.sgml**: 20260519

**ACCESSION NUMBER**: 0001325697-26-000006

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20260515

**FILED AS OF DATE**: 20260519

**DATE AS OF CHANGE**: 20260519

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** ANDREWS DEBORAH J
- **CENTRAL INDEX KEY:** 0001325697

**ORGANIZATION NAME:**

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-11634
- **FILM NUMBER:** 26998467

**MAIL ADDRESS:**
- **STREET 1:** 1911 WALKER AVE.
- **CITY:** MONROVIA
- **STATE:** CA
- **ZIP:** 91016
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** STAAR SURGICAL CO
- **CENTRAL INDEX KEY:** 0000718937
- **STANDARD INDUSTRIAL CLASSIFICATION:** OPHTHALMIC GOODS [3851]
- **ORGANIZATION NAME:** 08 Industrial Applications and Services
- **EIN:** 953797439
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 0102

**BUSINESS ADDRESS:**
- **STREET 1:** 1911 WALKER AVE
- **CITY:** MONROVIA
- **STATE:** CA
- **ZIP:** 91016
- **BUSINESS PHONE:** 6263037902

**MAIL ADDRESS:**
- **STREET 1:** 1911 WALKER AVE
- **CITY:** MONROVIA
- **STATE:** CA
- **ZIP:** 91016

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** STAAR SURGICAL COMPANY
- **DATE OF NAME CHANGE:** 19920703

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>ANDREWS DEBORAH J<br><sub>(Last) (First) (Middle)</sub><br>25510 COMMERCENTRE DRIVE<br><sub>(Street)</sub><br>LAKE FOREST, CA 92630<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2026-05-15 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Interim Co-CEO and CFO_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>STAAR SURGICAL CO [ STAA ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2026-05-15 |  | A |  | 10466 | A | $0 | 10466 | D |  |
| Common Stock | 2026-05-15 |  | F |  | 3755<sup>(1)</sup> | D | $32.07 | 15297 | D |  |
| Common Stock | 2026-05-15 |  | A |  | 5233 | A | $0 | 20530 | D |  |
| Common Stock | 2026-05-15 |  | F |  | 1877<sup>(2)</sup> | D | $32.07 | 18653 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Performance Stock Units | $0 | 2026-05-15 |  | M |  | 10466 |  | <sup>(3)</sup> | 2027-12-31 | Common Stock | 10466 | $0 | 10466 | D |  |
| Performance Stock Units | $0 | 2026-05-15 |  | M |  | 5233 |  | <sup>(4)</sup> | 2027-12-31 | Common Stock | 5233 | $0 | 15699 | D |  |

---

### Footnotes:

(1) On May 15, 2026, the first tranche of 10,466 performance stock units ("PSUs") awarded to the Reporting Person under the Issuer's 2025 Performance Stock Unit Award Program ("2025 PSU Program") in connection with her new hire grant vested, of which 3,755 shares were withheld to satisfy taxes .

(2) On May 15, 2026, the second tranche of 5,233 PSUs awarded to the Reporting Person under the 2025 PSU Program in connection with her new hire grant vested, of which 1,877 shares were withheld to satisfy taxes.

(3) Represents the settlement of the first tranche of performance stock units awarded to the Reporting Person in connection with her new hire grant under the 2025 PSU Program. The number of shares earned was determined upon certification by the Compensation Committee based on achievement of applicable performance goals. The original grant was exempt pursuant to Rule 16b-3(d) and was not previously reported.

(4) Represents the settlement of the second tranche of performance stock units awarded to the Reporting Person in connection with her new hire grant under the 2025 PSU Program. The number of shares earned was determined upon certification by the Compensation Committee based on achievement of applicable performance goals. The original grant was exempt pursuant to Rule 16b-3(d) and was not previously reported.

**Remarks:**
The Issuer's 2025 Performance Stock Unit Award Program ("2025 PSU Program") was designed to incentivize growth over a multi-year period. Under the 2025 PSU Program, performance is measured based on the Company's trailing four-quarter revenue through the end of fiscal 2027. The performance stock units ("PSUs") were granted based on a target number of shares and can be earned between 0-200 percent of target based on Company performance. The PSUs were structured into five tranches, each with different targets for trailing four-quarter U.S. GAAP revenue. Trailing four quarter U.S. GAAP revenue is measured as of the end of each financial quarter, commencing with the fourth quarter of fiscal 2025 and continuing through the fourth quarter of fiscal 2027. If none of the targets are achieved as of the end of fiscal 2027, the PSUs will not be earned and be forfeited. If the first three targets are achieved as of the end of fiscal 2027, the PSUs will be earned at 100 percent of target. If all five targets are achieved as of the end of fiscal 2027, the PSUs will be earned at 200 percent of target. Each PSU represents the right to receive one share of the Issuer's common stock.

**Signature:** /s/ Deborah J. Andrews  
**Date:** 2026-05-19

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**