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Visian implantable collamer lens vertical rotation in cases of excessive vault

Poster Details

First Author: P.Silva Guerra PORTUGAL

Co Author(s):    J. Fernandes   D. Lopes   P. Mouro              

Abstract Details


To report a case of decreased vault of a Visian Implantable Collamer Lens (ICL, STAAR Surgical) oversized, after rotation of the lens in the posterior chamber.


Cascais Hospital - Lisbon


Patient presented with a vault of 2 corneal thickness (CT) following spherical ICL (V4C 13,2mm) horizontal implantation in the first eye. On examination the UCVA: 20/20, IOP: 9mmHg and anterior segment revealed a slit anterior chamber and an anterior bow of the iris. Gonioscopy showed a grade 1 angle (Schaffer). SL-OCT was performed which demonstrated a vault of 955um and a vertical angle-to-angle dimension of 12,8 mm compared with the horizontal length of 12,2 mm. Given the excessive vault, the risk of angle closure, pigment dispersion and endothelial lesion, we performed rotation of the lens to vertical position.


After rotation the vault decrease to 479um (50,1% decrease), allowing the opening of the angle and ensuring that critical distances were maintained.


Vertical rotation of the visian ICL improved the vault to an acceptable size and should be considered in cases of excessive lens diameter as an alternative to explantation.

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