ESCRS - POREF129 - Accuracy And Predictability Of Ai-Based Postoperative Vault Simulation For Implantable Collamer Lens Sizing

Accuracy And Predictability Of Ai-Based Postoperative Vault Simulation For Implantable Collamer Lens Sizing

Published 2026 - 44th Congress of the ESCRS

Reference: POREF129 | Type: Free paper | DOI: 10.82333/zavw-z549

Authors: Dr Maria A. Henriquez* 1 , Dr Tatiana Andrea Arévalo-Barboza 1 , Mr Rolando Rojas 1 , Mr Jose Chauca 2 , Dr Luis Izquierdo Jr 3

1Research Department,Oftalmosalud Institute of Eye,Lima,Peru, 2Research Department,Oftalmosalud Institute of Eye,Lima,Peru;Department of Statistics, Demography, Humanities and Social Sciences,Universidad Peruana Cayetano Heredia,Lima,Peru, 3Research Department,Oftalmosalud Institute of Eye,Lima,Peru;San Fernando School of Medicine,Universidad Nacional Mayor de San Marcos,Lima,Peru

Purpose

To evaluate the accuracy and precision of an AI-based postoperative vault simulation software (ICL Guru) in eyes undergoing implantable collamer lens (ICL) surgery.

Setting

Research Department at Ofttalmosalud, Instituto de Ojos, Lima, Peru.

Methods

This prospective, consecutive case-series study included 32 KC eyes evaluated between October 2024 and October 2025. Preoperative parameters—obtained via Accutome high-frequency ultrasound biomicroscopy —were processed using the ICL Guru software to determine ICL sizing and predict postoperative vault and iridocorneal angles. Accuracy was assessed by comparing these predicted values against actual clinical outcomes at one month postoperatively. Anterior segment OCT (MS-39, CSO) was utilized for postoperative measurements.

Results

Mean predicted vs. actual postoperative values were: Central vault: 681.28±196.07 μm vs. 441.34±146.73 μm (p<.001), Iridocorneal Angle: 22.84±4.81∘ vs. 22.84±5.32∘ (p=0.38). The mean predicted minimum and maximum vault ranges were 150−400 μm and 460−850 μm, respectively, while the postoperative central vault range was 229−878 μm. Optimal vaulting was achieved in 90.62% of eyes; only three eyes (9.37%) presented a postoperative central vault lower than 250 μm (239 μm, 245 μm, and 241 μm). Moderate to strong positive correlations were observed between simulated and postoperative data: central vault (r=0.55, p<.001), peripheral vault (r=0.52, p<.001), and iridocorneal angle (r=0.48, p<.001).

Conclusions

The AI-based ICL Guru software demonstrated good predictability and correlation in simulating vault and angles for ICL sizing. While mean differences exist between predicted and actual values, the software serves as a valuable clinical decision-support tool for ILC sizing calculations.