Early Experience With Icl Guru: Predicted Vs Achieved Vault For Implantable Collamer Lens Surgery

To report  sizing outcomes using the ICL Guru sizing software in conjuction with UBM (sonomed Escalon). The predicted vs. achieved outcomes for myopic ICL vault are described.

Single centre private practice refractive surgery clinic in Dublin, Ireland

Sixty one myopic eyes are included in the analysis. ACD ranged from 2.51mm to 3.57. Refraction ranged from -2.25 to -18.0 SE. Each eye underwent UBM (Sonomed Escalon) and AS-OCT (MS-39) imaging which was analysed by the ICL Guru software. The ICL Guru software then generates a report predicting post-operative vault for each size of ICL depending on the ICL's power. The predicted vs achieved vaults are measured on AS-OCT (MS-39) and reported at day one and month one. We also include results on the post op anterior chamber angle values. ICL power ranged from -14.24 SE to -3.0 SE with an average SE of -7.94. 

No patients lost lines of BCVA. 54% gained BCVA of one line or more at the time of their 1 month visit. Average post op vault at day 1 was 517.3 microns, month 1 was 445.9. Average delta in vault prediction vs. achieved at 1 month was -35.33 microns. Percentage of cases with a predicted vs achieved vault delta <50 microns: 39.3%; <150microns: 78.7%; <250microns 96.7%; <390 microns: 100%. Achieved vault at day 1 between 0-150 microns: 0%; 150-250 microns: 4.9%; 250-800 microns: 93.%; 800-1000 microns: 1.6%; >1000 microns: 0%. Achieved vault at month 1 between 0-150 microns: 0%; 150-250 microns: 8.2%; 250-800 microns: 92.8.%; 800-1000 microns: 0%; >1000 microns: 0%. Post op anterior chamber angles measurments: <15: 0%; <20: 1.6%; >20: 98.3%

Using ICL Guru to choose myopic ICL size resulted in a safe vault (150-1000 microns), and safe anterior chamber angle (>15 degrees) in 100% of eyes. This sizing methodology gives the surgeon increased confidence that a safe ICL size can be chosen.