Icl Sizing Precision And Calculation Methods According Ubm Vs Oct

To enhance sizing accuracy of Phakic Collamer EVO ICL and compare differences between Sulcus-to-Sulcus (UBM) and AS-OCT (CASIA 2) measurements.

Retrospective study at a refractive surgery clinic in Spain

The study assessed 76 eyes, utilizing Pentacam HR, CASIA2 OCT, and UBM Quantel Medical for preoperative measurements. Lens size was determinde by OCOS recommendations and adjusted by surgeon´s clinical judgment. Postoperative vault was measured at 1 month with CASIA 2 OCT.

Surgeon-modified sizing achieved a safe and effective vault range, with most lenses sized at 12.6 mm and 13.2 mm. Despite OCOS suggesting larger lenses in most cases, surgeons often selected smaller sizes, occasionally using vertical implantation to fine-tune the vault. While Nakamura´s formula better matched the surgeons´ sizing decisions, its vault predictions were generally inaccurate, showing a lower-than-expected mean vault. The clinical outcome was a consistently safe Vault range, demonstrating that the clinical experience of the experienced surgeon provides greater confidence than predictive formulas.

Vault prediction by the Nakamura formula should not be a determining factor in lens sizing due to its inaccuracy. Instead, the surgeon´s clinical expertise is paramount, ensuring safe and reliable outcomes. The study advocates for a surgeon-centric approach over reliance on predictive models for ICL sizing and postoperative vault estimation