Exploring Nomograms for Implantable Collamer Lens Size Selection in Myopia: A Literature-based Compilation

Area of Science:

• Ophthalmology
• Refractive Surgery
• Biomedical Engineering

Background:

• Accurate sizing of implantable collamer lenses (ICLs) is crucial for achieving optimal refractive outcomes and minimizing complications in myopic patients.
• Various nomograms and preoperative diagnostic tools exist for ICL sizing, but a comprehensive overview is lacking.
• Understanding the available nomograms and their associated diagnostic requirements is essential for clinical decision-making.

Purpose of the Study:

• To compile a comprehensive guide of all available implantable collamer lens (ICL) sizing nomograms.
• To identify the specific preoperative diagnostic devices required for each ICL sizing nomogram.
• To assist clinicians in selecting the appropriate ICL size for myopic patients to optimize postoperative vault height.

Main Methods:

• A systematic literature search was performed to identify peer-reviewed articles on ICL sizing methods and outcomes.
• Articles detailing ICL nomograms or sizing formulas were analyzed.
• Preoperative variables and required diagnostic devices (topography, biometry, ultrasound biomicroscopy) for each nomogram were recorded.
• An additional search focused on identifying artificial intelligence (AI) or machine learning (ML)-derived nomograms.

Main Results:

• Eighteen distinct ICL sizing nomograms were identified.
• Five nomograms utilize topography or biometry: Manufacturer's, Optimized WTW, Kang, Kim, and Rocamora.
• Eight nomograms require ultrasound biomicroscopy (UBM): Kojima, Nakamura, KS, ZZ, Dougherty, Parkhurst, Russo, and Reinstein.
• Four nomograms are derived from AI/ML: Shen, Rocamora, Russo, and Kang.

Conclusions:

• ICL nomograms are indispensable tools for selecting the correct ICL size in myopic patients, thereby optimizing postoperative vault and reducing complication risks.
• Clinicians can integrate specific nomograms into their practice based on the availability of diagnostic devices like topography, biometry, or UBM.