Biometric and ICL-related risk factors associated to sub-opt
To identify biometric and implantable Collamer lens (ICL)-related risk factors associated with a sub-optimal postoperative vault in eyes implanted with phakic implantable Collamer lens. This study reports a retrospective case series of the first operated eye in 360 patients implanted with a myopic spherical or toric implantable collamer lens. Preoperatively, white-to-white (WTW), central keratometry (Kc), and central corneal thickness (CCT) were measured using the Pentacam. Anterior-segment optical coherence tomography (AS-OCT, Visante) was applied preoperatively for measuring the horizontal anterior-chamber angle-to-angle distance (ATA), internal anterior chamber depth (ACD), crystalline lens rise (CLR), anterior-chamber angle (ACA), and postoperatively the vault. Eyes were divided into three vault groups.

MLR showed that crystalline lens rise, implantable Collamer lens size minus the ATA (implantable Collamer lens size-ATA), age, implantable Collamer lens spherical equivalent (ICLSE), and implantable Collamer lens size as contributing factors for sub-optimal vaults. Increased crystalline lens rise and less myopic implantable Collamer lens spherical equivalent were risk factors for low vaults. Larger implantable Collamer lens size-ATA and the 13.7 mm implantable Collamer lens were risk factors for high vaults, whereas less myopic implantable Collamer lens spherical equivalent and older age were protective factors.

High crystalline lens rise and low implantable Collamer lens spherical equivalent were the major risk factors in eyes presenting low vaults. In the opposite direction, implantable Collamer lens size-ATA was the major contributor for high vaults. This relationship was more critical in higher myopic implantable Collamer lens spherical equivalent, younger eyes, and when 13.7 mm ICL were used. The findings show that factors influencing the vault have the differentiated weight of influence depending on the type of vault (low, optimal, or high).