Short-term changes in lens vault post implantable collamer lens surgery in myopic patients

Abstract

Purpose: To evaluate short-term postoperative changes in lens vault and associated ocular parameters following Implantable Collamer Lens (ICL) implantation in myopic patients, and to identify preoperative predictors of vault behavior during the initial 15 days after surgery.
Subject and Methods: This cohort study included 202 eyes from 101 patients with myopia and astigmatism who underwent bilateral ICL implantation at Chaudhary Eye Centre & Laser Vision between October 2023 and December 2024. Preoperative and postoperative assessments included best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), and central vault measurements using the Anterion AS-OCT. Follow-ups were conducted on postoperative day 1 (POD 1) and day 15 (POD 15). Statistical analysis involved Wilcoxon tests, Fisher’s exact test, and mixed-model logistic regression to identify factors influencing vault changes.
Results: A significant reduction in lens vault was observed between POD 1 and 15 (mean difference = 50.5 μm; p < 0.001). ACD increased (mean = 0.0399 mm; p < 0.001), while IOP decreased (mean = 1.5 mmHg; p < 0.001). BCVA showed modest improvement (p = 0.041). Vault decreased in 75.2% of eyes, remained unchanged in 2%, and increased in 22.8%. Multivariate analysis revealed spherical equivalent (SE) as the only significant predictor of vault reduction (p < 0.001), with higher myopia associated with greater vault decrease.
Conclusion: Early postoperative changes in vault are significantly influenced by the degree of myopic correction. Higher preoperative myopia is associated with greater vault reduction, underscoring the importance of individualized preoperative planning and early postoperative monitoring to ensure optimal outcomes following ICL implantation.