Abstract
PURPOSE: 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). SETTING: Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China. DESIGN: Retrospective observational study. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.