Abstract
PURPOSE: To evaluate the correlation between intraoperative vault measured by optical coherence tomography (OCT) and postoperative vault, and to assess dynamic changes in vault following EVO implantable collamer lens (ICL) implantation. SETTING: Eye and ENT Hospital of Fudan University. DESIGN: Prospective observational study. METHODS: This prospective study enrolled 14 patients (5 males, 9 females) who underwent EVO ICL implantation at the Eye and ENT Hospital of Fudan University between July and August 2024, involving a total of 27 eyes. The mean age of the patients was 25.5 ± 4.4 years (range: 19 to35 years), and the average manifest refraction spherical equivalent was - 7.84 ± 2.25 D (range: -11.63 to - 2.00 D). Intraoperative OCT was used to measure real-time vault height without the application of viscoelastic agents. Central vault was measured using CASIA-2 immediately after ICL implantation and reassessed at 1 day, 1 week, and 1 month postoperatively. At each follow-up, visual acuity, subjective and objective refraction, and anterior segment parameters were recorded. RESULTS: The mean intraoperative vault was 937.30 ± 402.27 μm. Postoperative vault measurements demonstrated a progressive decline: 912.00 ± 269.96 μm at 2 hours, 777.43 ± 252.19 μm at 1 day, 722.22 ± 226.37 μm at 1 week, and 675.98 ± 224.34 μm at 1 month. A strong correlation was observed between intraoperative and postoperative vault values, with an r² of 0.827 at 2 hours. Bland-Altman analysis indicated a systematic bias of 39.63 μm, with 92.6% of eyes falling within the 95% limits of agreement. The anterior chamber depth to both the crystalline lens and ICL remained stable throughout the postoperative period. CONCLUSION: The vault measured by intraoperative OCT during EVO ICL implantation closely corresponded with postoperative measurements obtained via CASIA-2, and vault decreased in the early postoperative period.