Evaluation Of The Use Of Intraoperative Oct In Measurement Of Implantable Collamer Lens Vaulting

To compare the intraoperative and postoperative vaulting in patients undergoing implantable collamer lens (ICL) implantation and evaluate the use of intraoperative optical coherence tomography (iOCT) in ICL surgery.

A total of 345 eyes of 176 consecutive patients who underwent ICL implantation surgery using iOCT with complete surgical video from January 2022 to October 2022 at Beijing Aier Intech Eye Hospital were included. The cases were divided into two groups according to the type of ICL, the ICL group and the toric ICL (TICL) group. Intraoperative ICL vaulting was measured by microscope-integrated iOCT system (Zeiss Rescan 700), and the vaulting was measured by frequency-domain optical coherence tomography (FD-OCT) at postoperative 1 day (POD1) and 1 month (POM1).

The mean ICL vaultings were 428.60±167.36 μm, 683.00±240.48 μm and 579.5±210.55 μm intraoperatively, POD1 and POM1, respectively. Correlation analysis showed significant agreement, POD1 (R²=0.55, P <0.001)，POM1 (R²=0.49, P <0.001). The intraoperative vaulting was less than 250 μm in 41 cases, but only 3 cases were still less than 250 μm at POD1. The intraoperative vaulting was over 750 μm in 20 cases, and 18 cases were still over 750 μm at POD1. 21.70% (51/235) eyes of the ICL group were underwent ICL rotation intraoperatively aided by iOCT. The mean vault values at POD1 and POM1 in the ICL group were 638.18±218.57 μm and 556.91±206.21 μm. In TICL group, they were 765.81±266.09 μm (p < 0.001) and 636.72±214.18 (p=0.011).

Intraoperative ICL vaulting measured by iOCT was highly correlated with postoperative ICL vaulting. IOCT vaulting measurement could be used as a reliable indicator of the final ICL vault. IOCT was better at predicting postoperative high vault compared to low vault. To achieve an ideal vault, intraoperative ICL rotation aided by iOCT was a useful treatment.