Abstract
This study aimed to compare the achieved vault using a manufacturer’s nomogram and the predicted vault using the currently available prediction formulas after posterior chamber phakic intraocular lens (EVO Implantable Collamer Lens; ICL, STAAR Surgical) implantation. We included 200 eyes of 100 consecutive patients (mean age ± standard deviation, 34.3 ± 7.8 years) undergoing ICL implantation with a central hole. Three months postoperatively, we quantitatively measured the actual vault, and we compared it with the predicted vault using anterior segment optical coherence tomography (CASIA 2, Tomey). The agreement rate of the recommended ICL size using the manufacturer’s nomogram, the NK formula, and the KS formula was 50.0%. The achieved vault was 477.1 ± 263.7 µm, which was significantly smaller than the predicted vaults of 551.2 ± 335.1 and 606.4 ± 212.2 µm, using the NK and KS formulas, respectively (Dunnett test, p = 0.014, p < 0.001). The achieved vault was not significantly different from the predicted vault using the NK or KS formula (p = 0.386, p = 0.157) when selecting a 12.1 mm ICL size. It was not significantly different from the predicted vault using the NK formula (p = 0.962), but it was significantly smaller than that using the KS formula (p = 0.033) when selecting a 12.6 mm size. It was significantly smaller than the predicted vault using the NK and KS formulas (p < 0.001) when selecting 13.2 mm size. The total agreement rate of the recommended ICL size was approximately 50%. The predicted ICL vault tended to overestimate the actual ICL vault, especially when selecting a larger ICL size.
Highlights
The EVO Implantable Collamer Lens (ICL; Visian ICL with KS-AquaPORT; STAAR Surgical, Monrovia, CA, USA), a posterior chamber phakic intraocular lens, has been well-recognized as a long-term, safe, and effective means to correct moderate to high refractive errors all over the world [1,2,3,4]
Our findings demonstrated that the achieved postoperative ICL vault was significantly smaller than the predicted ICL vault using the NK and KS formulas in the study population, and the predicted ICL vault tended to overestimate the actual ICL vault, especially when selecting a larger ICL size (13.2 mm size)
Our study showed that the total agreement rate of the recommended ICL size among the three methods was only 50.0%
Summary
The EVO Implantable Collamer Lens (ICL; Visian ICL with KS-AquaPORT; STAAR Surgical, Monrovia, CA, USA), a posterior chamber phakic intraocular lens, has been well-recognized as a long-term, safe, and effective means to correct moderate to high refractive errors all over the world [1,2,3,4]. The NK and KS formulas have become commercially available for predicting the ICL vault and selecting the optimal ICL size, based on an AS-OCT device (CASIA2, Tomey, Nagoya, Japan) [7,8,9]. To the best of our knowledge, the achieved and predicted ICL vault using these formulas has, to date, not been validated in any other population. It may give us essential prospects on the practical use of the two prediction formulas in a clinical setting. The purpose of the current study was twofold: to determine the agreement rate of the recommended ICL size using the manufacturer’s nomogram and the two prediction formulas; and to compare the achieved and predicted ICL vault using the two formulas according to the ICL size selected
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