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Vault changes in eyes with a vertically implanted implantable collamer lens.

Masayuki Ouchi1

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Vertical fixation of implantable collamer lenses (ICL) results in a lower vault than predicted. This study found vertical ICL fixation reduced vault by over 100 μm compared to horizontal fixation.

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Area of Science:

  • Ophthalmology
  • Medical Optics
  • Biomedical Engineering

Background:

  • The sulcus-to-sulcus vertical diameter exceeds the horizontal diameter.
  • The impact of vertical implantable collamer lens (ICL) positioning on postoperative vault relative to preoperative predictions remains unclear.

Purpose of the Study:

  • To investigate postoperative and preoperative predicted vaults in patients undergoing vertical ICL fixation.
  • To compare vault outcomes between vertical and horizontal ICL fixation methods.

Main Methods:

  • Prospective consecutive case series involving 180 patients with myopic astigmatism.
  • Patients were divided into horizontal (n=90) and vertical (n=90) ICL fixation groups.
  • Anterior segment optical coherence tomography (A-OCT) was used for biometrics at multiple postoperative time points.

Main Results:

  • Anterior chamber depth remained stable and showed no significant difference from preoperative values in either group.
  • Postoperative vault was significantly lower in the vertical fixation group compared to the horizontal fixation group.
  • The discrepancy between measured and predicted vault was significantly greater in the vertical group.

Conclusions:

  • Vertical ICL fixation leads to a greater-than-expected reduction in vault compared to horizontal fixation.
  • Vertical ICL fixation reduced vault by over 100 μm, deviating from A-OCT predictions.