Abstract
BackgroundTo evaluate clinical factors affecting postoperative vaulting in eyes that had achieved optimal vaulting within the range of 250–750 μm following implantation of 12.6-mm V4c implantable collamer lenses (ICL).MethodsA total of 236 eyes of 236 patients that had achieved optimal vaulting following implantation of a 12.6-mm V4c ICL were retrospectively analyzed. Associations between postoperative vaulting and age, preoperative anterior chamber depth (ACD), preoperative axial length (AL), preoperative white-to-white diameter, preoperative pupil size, preoperative sulcus-to-sulcus diameter, and preoperative manifest refraction spherical equivalent were investigated using simple regression, stepwise multiple regression, and multinomial logistic regression analyses.ResultsMean central vaulting at the 6-month follow-up was 519.0 ± 112.8 μm. Variables relevant to postoperative vaulting were, in order of influence, preoperative ACD (β = 0.305, p < 0.001), preoperative pupil size (β = 0.218, p < 0.001), and preoperative AL (β = 0.171, p = 0.006). Low preoperative pupil size was associated with low optimal vaulting (250 to 450 μm), relative to that observed in the mid optimal vaulting group (451 to 550 μm) (odds ratio = 0.532, P = 0.021). Increasing preoperative ACD was associated with high optimal vaulting (551 and 750 μm), relative to that observed the mid optimal vaulting group (odds ratio = 6.340, P = 0.034).ConclusionsMyopic eyes with greater preoperative ACD, larger pupil size, and longer AL are predisposed to higher postoperative vaulting following 12.6-mm V4c ICL implantation. Therefore, the extremes of these parameters should be considered when choosing V4c ICL size.
Highlights
To evaluate clinical factors affecting postoperative vaulting in eyes that had achieved optimal vaulting within the range of 250–750 μm following implantation of 12.6-mm V4c implantable collamer lenses (ICL)
Similar to findings observed for anterior chamber depth (ACD), our results suggested that smaller pupil diameters were associated with low optimal vaulting values
In the present study, we demonstrated that preoperative ACD, followed by preoperative pupil size and preoperative axial length (AL), significantly influenced postoperative vaulting following 12.6-mm V4c ICL implantation in eyes that had achieved optimal vaulting within the range of 250– 750 μm
Summary
To evaluate clinical factors affecting postoperative vaulting in eyes that had achieved optimal vaulting within the range of 250–750 μm following implantation of 12.6-mm V4c implantable collamer lenses (ICL). Lee et al BMC Ophthalmology (2018) 18:163 vaulting conditions have been reported to induce mechanical contact between the ICL and crystalline lens and cause inadequate aqueous circulation in the perilenticular space. Values at the low end of this range (250 μm) may be associated with peripheral crystalline lens contact, while values at the high end of this range (750 μm) may be associated with synechial angle closure. Both optimal vaulting status and the extent of vaulting achieved within the optimal range may be relevant to the selection of ICL size
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