Three-year follow-up of subjective vault following myopic implantable collamer lens implantation.

PURPOSE

To evaluate changes of subjective vault during a period of 36 months after implantation of phakic posterior chamber implantable collamer lens (ICL) for myopia correction.

METHODS

Nine hundred and sixty four myopic eyes of 531 patients, 353 females (66.5%) and 178 (33.5%) males, who received a Visian ICL (model V4, Staar Surgical Inc.) implantation were included in the study. Subjective vault classified in five levels (0, 1, 2, 3 and 4) was assessed at each of the follow-up visits by a trained ophthalmologist during a period of 36 months.

RESULTS

Mean vault decreased from 2.30 ± 0.87 immediately after surgery to 2.10 ± 0.92 at 12 months and to 2.06 ± 1.05 at 36 months. For patients presenting vault 2, 3, and 4 post-operatively, there was a decrease with time, with changes becoming statistically significant (p < 0.05) after the 3-month follow-up visit. The few eyes developing anterior subcapsular cataract (ASC) were older, had a tendency to vault 2 or lower post-operative, shallower anterior chamber depth and smaller ICL size. Eyes with acute increase in intraocular pressure (IOP) were significantly more myopic, had smaller white-to-white diameter and had larger photopic pupil diameters.

CONCLUSIONS

Decrease in subjective vault after ICL implantation became statistically significant after the third month postoperatively. Several patients and lens-related factors have been identified as potential predictors of ASC or acute increase in IOP. A tight follow-up during the critical post-operative period should be considered in those particular cases.