Central vault after phakic intraocular lens implantation: Correlation with anterior chamber depth, white-to-white distance, spherical equivalent, and patient age

• Published in: Journal of cataract and refractive surgery Vol. 38; no. 1; pp. 46 - 53
• Main Authors: Alfonso, José F., MD, PhD, Fernández-Vega, Luis, MD, PhD, Lisa, Carlos, MD, Fernandes, Paulo, OD, Jorge, Jorge, PhD, Montés Micó, Robert, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2012; Elsevier
• Subjects: Adult; Age Factors; Anterior Chamber - pathology; Astigmatism - surgery; Biological and medical sciences; Cohort Studies; Cornea - anatomy & histology; Female; Humans; Hyperopia - surgery; Lens Implantation, Intraocular; Male; Medical sciences; Middle Aged; Myopia - surgery; Ophthalmology; Phakic Intraocular Lenses; Postoperative Complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Tomography, Optical Coherence; Young Adult; Human; Correlation; Treatment; Surgery; Implantation; Anterior chamber; Ophthalmology; Caucasoid; Intraocular lens; Age; Distance; Depth
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2011.07.035

Purpose To compare the central postoperative vault of a phakic intraocular lens (pIOL) to correct myopia, myopic astigmatism, and hyperopia and identify ocular and lens parameters that might predict the vault amount. Setting Fernández-Vega Ophthalmological Institute, Oviedo, Spain. Design Cohort study. Methods Three months after implantation of Implantable Collamer Lens pIOLs to correct myopia, hyperopia, and myopic astigmatism, central vault was measured using optical coherence tomography. Patients were divided into groups according to the preoperative anterior chamber depth (ACD) to compare the effects of ACD, white-to-white (WTW) distance, and lens diameter on postoperative pIOL vault. Results Hyperopic pIOLs had statistically significantly lower vault followed by myopic pIOLs and toric pIOLs, which had a higher mean value and narrower range (260 to 860 μm). Measured vaults had a positive correlation with preoperative ACD ( r = .32, P <.001) and WTW ( r = .29, P <.001) and a negative correlation with preoperative spherical equivalent (SE) ( r = −0.21, P <.001) and patient age ( r = −0.12, P =.025). Eyes with a vault of 250 μm or less had a shallower ACD than eyes with a vault between 250 μm and 750 μm (mean difference −0.11 mm; P =.012) and those with a vault greater than 750 μm (mean difference −0.25 mm; P <.001). Conclusions Central vaulting was lower in hyperopic eyes. Current nomograms for pIOL diameter selection based on ACD and WTW might yield ideal vault and may have to be adjusted for older patients, shallower ACD, lower WTW, and lower SE. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.