Abstract
BackgroundTo describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault.MethodsEighty-three eyes from eighty-three subjects with complete data who met follow-up requirements were recruited in this retrospective study between May 2019 and March 2020. We quantitatively assessed the postoperative vault at 2 h, 1 day, 1 week, and 1 month following implantation. Associations between the postoperative vault and age, ICL size, spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), flat keratometry (K), steep K, mean K, anterior chamber depth (ACD), crystalline lens thickness (LT), white-to-white (WTW) diameter obtained by three devices, horizontal and vertical sulcus-to-sulcus (STS) diameter, bright and dark pupil sizes (BPS and DPS) and DPS-BPS were investigated using Spearman’s correlation analysis and stepwise multiple regression analysis.ResultsThe mean vault values at 2 h, 1 day, 1 week, and 1 month after ICL implantation were 672.05 ± 30.72, 389.15 ± 28.33, 517.23 ± 30.76 and 530.12 ± 30.22 μm, respectively. Significant differences were found in the vault values at 2 h, 1 day and 1 week after the operation. The ICL size (β = 0.942; p < 0.001), followed by horizontal STS (β = -0.517; p < 0.001), crystalline LT (β = -0.376; p < 0.001) and vertical STS (β = -0.257; p = 0.017), significantly influenced the vault at 1 month after the operation. The multiple regression equation was expressed as follows: central vault (µm) = -1369.05 + 657.121 × ICL size- 287.408 × horizontal STS − 432.497 × crystalline LT − 137.33 × vertical STS (adjusted R2 = 0.643).ConclusionsAfter ICL implantation, the vault decreased and then increased, but it did not return to the vault value 2 h after surgery. The ICL size, horizontal and vertical STS and crystalline LT are key factors for predicting postoperative vaulting.
Highlights
To describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault
The vault value was 672.05 ± 30.72 μm at 2 h after surgery, decreased to 389.15 ± 28.33 μm at 1 day increased to 517.23 ± 30.76 μm at 1 week after surgery
By analysing the full-scale Ultrasound biomicroscopy (UBM) of 134 eyes, Zhang et al [26] found that the ICL haptics in most cases were not in the ciliary sulcus and that different haptic positions had a significant influence on postoperative vaulting
Summary
To describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault. The Implantable Collamer Lens (ICL; STAAR Surgical Co, Monrovia, California) is a safe and effective option to correct myopia [1,2,3,4]. ICL implantation offers outstanding benefits, postoperative complications have been reported, most of which were associated with the vault (distance between the posterior ICL surface and anterior crystalline lens surface) inappropriateness [7, 8]. A low vault may lead to mechanical contact with the lens or inadequate aqueous humour circulation, accounting for the high incidence of anterior capsular opacity and cataract formation [9, 10]. A high vault can cause excessive mechanical contact between the ICL and iris, leading to inflammation and increased intraocular pressure [11, 12]. The occurrence of pigment dispersion syndrome, iris atrophy, and acute angle-closure glaucoma has been associated with a high vault [13,14,15]
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