Size exchange and vault response in posterior chamber phakic intraocular lens implantation: 12 years at a high-volume center

Key Points

• To assess how ICL exchange strategies affect vault changes over 12 years in a high-volume center.
• Analyzed vault outcomes after downsizing, same-size exchange, and upsizing strategies.
• Evaluated the impact of patient age and preoperative vault on outcomes.
• Conducted a long-term observational study.
• Downsizing consistently reduced excessive vault.
• Same-size exchange showed minimal vault change.
• Upsizing resulted in smaller vault increases, particularly in older patients.