Vault changes in eyes with a vertically implanted implantable collamer lens

Abstract This prospective consecutive case series examined the postoperative and preoperative predicted vaults during vertical fixation of an implantable collamer lens (ICL). This study assessed 180 right eyes of 180 patients with ICL implants for myopic astigmatism. For the 90 eyes of 90 patients who underwent horizontal fixation (horizontal group) and 90 eyes of 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 h (2h), 1 day (1d), 1 week (1w), and 1 month after surgery (1m). Anterior chamber depth and postoperative vault were compared between the two groups. The difference between the preoperative predicted vault calculated using the KS formula installed in the A-OCT and the postoperative actual measured value was examined. The anterior chamber depth did not change at 2h, 1d, 1w, and 1m in both groups, and there was no significant difference from the preoperative values. Postoperative vault values were significantly lower in the vertical group than in the horizontal group over time. The difference between the vault measured 1m after surgery and the preoperative predicted value was significantly larger in the vertical group than in the 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