Comparison of intraoperative vs postoperative optical coherence tomography measurement of implantable collamer lens vaulting

Abstract

Purpose:To compare intraoperative vs postoperative optical coherence tomography (OCT) measurements of implantable collamer lens (ICL) vaulting.Setting:American University of Beirut Medical Center, Beirut, Lebanon.Design:Prospective observational cohort study.Methods:Patients with myopia or myopic astigmatism undergoing ICL insertion in which intraoperative OCT measurements were obtained were included. Exclusion criteria included coexisting ocular problems and previous ocular surgery. The outcome measures were ICL vaulting as determined by OCT intraoperatively and postoperatively at 1 day, 1 week, 1 month, and 3 months.Results:Forty-five eyes of 26 patients were included. Mean age was 27.23 ± 6.47 years (range 17 to 48 years), and mean manifest refraction spherical equivalent was-10.20 ± 3.92 diopters (D) (range-20.50 to-4.50 D). Mean ICL vaulting measured 731 ± 215 m intraoperatively, 648 ± 219 m at 1 day, 640 ± 204 m at 1 week, 628 ± 212 m at 1 month, and 632 ± 210 m at 3 months postoperatively (P =.0009, with all postoperative vaulting measurements statistically similar to each other, but significantly different from the intraoperative measurement). However, intraoperative ICL vaulting had high predictability of postoperative vaulting at 3 months with r2= 0.81 (P <.0001), and Bland-Altman analysis demonstrates a relatively constant difference between the 2 measurements as plotted against their mean with a bias of 98.27 m and tight 95% limits of agreement range.Conclusions:Intraoperative ICL vaulting measured by OCT correlated highly with postoperative OCT vaulting and can be considered a reliable tool to predict the final ICL vault. © 2020 Elsevier Inc.. All rights reserved.