Effects of crystalline lens characteristics on vault after implantable collamer lens implantation

To investigate the association between crystalline lens characteristics and postoperative vault in highly myopic eyes following implantation of Implantable Collamer Lens V4c (ICL V4c; STAAR Surgical). Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China. Retrospective observational study. This retrospective study included 199 eyes from 199 patients who underwent ICL implantation. Crystalline lens Dimensional parameters were quantified using CASIA 2 swept-source anterior segment optical coherence tomography. Based on vault height measured 3 months postoperatively, eyes were classified into low (< 250 µm), optimal (250-750 µm), or high (> 750 µm) vault groups. Group comparisons, Spearman correlation, and multivariate logistic regression analyses were performed to identify factors associated with low vault outcomes. Significant differences were observed in white-to-white (WTW), anterior chamber depth (ACD), anterior radius of curvature (ARC), posterior radius of curvature (PRC), lens thickness (LT), and decentration among the different vault groups (all P < 0.001). Multivariate logistic regression analysis identified a significant negative association between low vault and both ARC and lens tilt, after adjusting for age, gender and spherical equivalent (all P < 0.05). Crystalline Lens parameters play a critical role in determining postoperative vault following ICL implantation. Steeper anterior curvature and greater lens tilt may be anatomic indicators of a predisposition to low postoperative vault outcomes.