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Optimization of vision implantable collamer lens vault by intentional rotation

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Session Details

Session Title: Phakic IOLs

Session Date/Time: Monday 09/10/2017 | 08:30-10:20

Paper Time: 09:00

Venue: Meeting Center Room I

First Author: : D.Lee SOUTH KOREA

Co Author(s): :    S. Kim   H. Koo                 

Abstract Details


(1) To evaluate ciliary sulcus diameters in horizontal and vertical axes (HSTS and VSTS) and (2) To quantify vault change by intentionally rotated spherical Visian Implantable Collamer Lens (ICL, V4c model) in eyes with vertically oval sulcus and postoperative high vault.


Nunemiso eye clinic, Seoul, Korea


A total of 827 myopic ICL candidates were divided into circular (0≤VSTS–HSTS<200 µm), horizontally oval (VSTS–HSTS<0 µm) and vertically oval (VSTS–HSTS≥200 µm) sulcus group with preoperative ultrasound biomicroscopy (UBM). Among the eyes which had vertically oval sulcus and showed high vault (>800 μm) after ICL implantation, longitudinal axis of ICL was intentionally rotated from horizontal to oblique or vertical position by the amount of angle θ in order to decrease and thus optimize vault. The achieved vault change (AVC) were compared with mathematically-estimated expected vault change (EVC) derived from the equation of ellipse in the Cartesian axes.


Circular sulcus group was 97 eyes (11.7%) and horizontally oval sulcus group was 20 (2.4%). Among vertically oval group (710 eyes, 85.9%), 41 eyes showed high vault. After mean rotation of 57±26 degrees, mean vault was decreased from 1082±160 to 755±140 µm. AVC (326±170 µm) showed significant positive correlation with EVC (295±115 µm). (Spearman's rho =0.752, p<0.001,)


The ICL vault change by intentional rotation could be quantitatively estimated with the function of rotated angle θ, HSTS and VSTS on the assumption that sulcus structure is ellipsoid. Thus we may manage postoperative inadequate high vault without ICL exchange or optimize it, given that fine tuning of effective lens position is preferable in impending diffractive multifocal ICL optics.

Financial Disclosure:


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