Vault Changes In Eyes With A Vertically Implanted Implantable Collamer Lens

Vertical fixation of the implantable collamer lens (ICL) has received much attention in recent years with better rotational stability owing to its anatomical characteristics. However, sulcus-to-sulcus vertical diameter is longer than the horizontal, and the effect of vertical positioning of the ICL on the vault compared to preoperative prediction is unclear. This prospective consecutive case series aimed to examine postoperative and preoperative predicted vaults during vertical ICL fixation.

Single center prospective case series

One hundred and eighty right eyes in 180 patients with myopic astigmatism were included. For the 90 eyes in 90 patients who underwent horizontal fixation (horizontal group) and 90 eyes in 90 patients who underwent vertical fixation (vertical group), biometrics by three-dimensional tomography of the anterior segment optical coherence tomography (A-OCT) was performed before surgery and 2 hours, 1 day, 1 week, 1month and 3 months after surgery.

The anterior chamber depth did not change over time in both groups, and there was no significant difference from preoperative values. The postoperative vault values were significantly lower in the vertical group than in horizontal group over time. The difference between vault measurements and preoperative predictions at all postoperative time points was significantly greater in the vertical group than in horizontal group.

Vertical fixation of the ICL reduced the vault by > 100 μm compared with horizontal fixation, which was different from the A-OCT preoperative predicted value.