Prediction Of Vault At 1 Month For The Implantable Collamer Lens (Icl) Using Intraoperative Vault By Oct
Published 2023 - 41st Congress of the ESCRS
Reference: FP03.01 | Type: Free paper | DOI: 10.82333/h5mn-j716
Authors: Maxwell Reinstein* 1 , Dan Reinstein 2 , Timothy Archer 1
1Reinstein Vision, London Vision Clinic,London,United Kingdom, 2Reinstein Vision, London Vision Clinic,London,United Kingdom;Columbia University Medical Center,New York, NY,United States;Sorbonne Université,Paris,France;Biomedical Science Research Institute, Ulster University,Coleraine,United Kingdom
Purpose
To investigate the use of intraoperative lens separation vault measurements by intraoperative 3D OCT (ARTEVO 800, Carl Zeiss Meditec) in predicting the 1 month vault of the Implantable Collamer Lens (ICL) (STAAR Surgical).
Setting
London Vision Clinic, London, UK
Methods
Retrospective analysis of consecutive V4c EVO and EVO+ ICL procedures. ICL size was chosen using Insight 100 VHF digital ultrasound (ArcScan Inc) posterior chamber measurements. OCT central vault was recorded intraoperatively, followed by a postoperative measurement at 1 month after surgery. The mean vault at each time point was calculated. Stepwise multiple linear regression analysis was used to evaluate the correlation between vault by intraoperative OCT and vault at 1 month. A formula including the intraoperative vault was made based on the results of the regression analysis to predict the vault at 1 month. After deriving this formula, a test set of 42 eyes was used to estimate its accuracy.
Results
A total of 149 eyes were included. Mean central vault was 799±304 µm intraoperatively and 604±169 µm at 1 month. The relationship between intraoperative and 1 month vault (P<0.001) showed that 1 month vault was higher if intraoperative vault was below 350 µm, and lower if intraoperative vault was above 650 µm. The regression analysis showed that intraoperative vault, ciliary body inner diameter, crystalline lens rise from the sulcus plane, lens size and patient age were statistically significant (P<0.001) in predicting the change between intraoperative and 1 month vault. Prospective use of the regression formula projected the 1 month vault of 40% of eyes to fall within 100 µm of the predicted value, 64% within 200 µm and 81% within 300 µm.
Conclusions
Given that an ideal vault should rest between 300 and 800 microns, intraoperative OCT employing this formula could prove a useful tool for intraoperative decision making with respect to on-the-table ICL size exchange avoiding a return to the operating room at a subsequent date.