Analysis of vault prediction in phakic implantable phakic collamer lenses: manufacturer’s calculator vs theoretical formulae vs clinical practice

Beltrán-Murcia, Jesús; Capelo, L. Alvarez-Rementería; Blázquez, Vanesa

doi:10.1007/s00417-023-06016-1

Cited by 4 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The WTW method has a high success rate. It has been reported to be the most predictable method available 21 and to result in an achieved vault that is not clinically or statistically different from other methods of size calculation ( Figure 4 ). 3 , 22 In the FDA clinical trial of the EVO ICLs, mean vault at 6 months was 492 ± 227 µm, and there were only two eyes (0.3%, 2/629) that required secondary surgical intervention for anterior chamber angle narrowing related to excessive vault, neither of which had elevated IOP.…”

Section: Planning Methodsmentioning

confidence: 92%

“… 16 , 46 However, the central port introduced with the EVO ICLs helps to maintain metabolism and reduce the likelihood of lens opacification compared to prior lens designs without a central port, even with a shallow vault. 10 , 21 , 22 , 42 , 46 Recent reviews have found rates of anterior subcapsular cataract of 0.0% 3 and 0.17% 4 for EVO ICL, with some cases in the latter review likely due to factors other than vault. Even in studies of EVO ICL eyes with very low vault of <250 µm or <100 µm, there have been few or no cases of anterior subcapsular cataract and no significant differences in lens density compared to a control.…”

Section: Discussionmentioning

confidence: 99%

“…Beltrán-Murcia et al recently reported that the best results in sizing and vault ICL calculation are obtained using the OCOS online calculator (OCOS), as long as Pentacam-derived ACW and CLR are used as accessory measurements to help the surgeon decide when to reduce the OCOS-recommended ICL by one size. 21 …”

Section: Planning Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Implantable Collamer Lens Procedure Planning: A Review of Global Approaches

Thompson,

Cummings,

Wang

2024

OPTH

View full text Add to dashboard Cite

More than 2 million implantable collamer lenses (ICLs) have been implanted worldwide. With a central port to improve aqueous flow through the ICL, the latest iteration of this phakic intraocular lens (pIOL) has been shown to have stable outcomes with very low rates of adverse events. However, correct planning and ICL size selection continue to be important to achieve an optimal vault. Shallow or excessive vaults are not complications in and of themselves but may increase the risk of complications. Historically, surgeons have relied on measurements of anterior chamber depth (ACD) and manual, caliper-measured white-to-white (WTW) distance to select the ICL size. New diagnostic and imaging technologies such as optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) provide additional opportunities for visualization and measurement of the intraocular dimensions involved in phakic intraocular lens implantation, including sulcus-to-sulcus (STS) and angle-to-angle (ATA) diameters. This paper reviews various approaches to ICL planning and sizing that have been published in the peer-reviewed literature, all of which produce acceptable results for predicting vault and size selection. Surgeons may also want to identify a methodology for patient evaluation and ICL size selection that best aligns with their personal preferences, diagnostic technology, and familiarity with analytical optimization tools.

show abstract

Section: Planning Methodsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Implantable Collamer Lens Procedure Planning: A Review of Global Approaches

Thompson,

Cummings,

Wang

2024

OPTH

View full text Add to dashboard Cite

show abstract

“…7 8 Nowadays, some studies have used formula regression methods to analyse the size of ICL. [9][10][11][12][13][14] These studies have incorporated a few parameters, leading to a poor fit in multiple parameter regressions, which does not adequately consider various aspects for predicting the ICL size. Thus, it is necessary to build an accurate ICL selection system.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Clinical decision support system based on deep learning for evaluating implantable collamer lens size and vault after implantable collamer lens surgery: a retrospective study

Yang,

Long,

Lei

et al. 2024

BMJ Open

View full text Add to dashboard Cite

ObjectivesTo aid doctors in selecting the optimal preoperative implantable collamer lens (ICL) size and to enhance the safety and surgical outcomes of ICL procedures, a clinical decision support system (CDSS) is proposed in our study.DesignA retrospective study of patients after ICL surgery.SettingChina Tertiary Myopia Prevention and Control Center.Participants2772 eyes belonging to 1512 patients after ICL surgery. Data were collected between 2018 and 2022.Outcome measuresA CDSS is constructed and used to predict vault at 1 month postoperatively and preoperative ICL dimensions using various artificial intelligence methods. Accuracy metrics as well as area under curve (AUC) parameters are used to determine the CDSS prediction methods.ResultsAmong the ICL size prediction models, conventional neural networks (CNNs) achieve the best prediction accuracy at 91.37% and exhibit the highest AUC of 0.842. Regarding the prediction model for vault values 1 month after surgery, CNN surpasses the other methods with an accuracy of 85.27%, which has the uppermost AUC of 0.815. Thus, we select CNN as the prediction algorithm for the CDSS.ConclusionsThis study introduces a CDSS to assist doctors in selecting the optimal ICL size for patients while improving the safety and postoperative outcomes of ICL surgery.

show abstract

Monte-Carlo simulation for calculating phakic supplementary lenses based on a thick and thin lens model using anterior segment OCT data

Langenbucher,

Cayless,

Kormanyos

et al. 2023

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Background Phakic lenses (PIOLs, the most common and only disclosed type being the implantable collamer lens, ICL) are used in patients with large or excessive ametropia in cases where laser refractive surgery is contraindicated. The purpose of this study was to present a strategy based on anterior segment OCT data for calculating the refraction correction (REF) and the change in lateral magnification (ΔM) with ICL implantation. Methods Based on a dataset (N = 3659) containing Casia 2 measurements, we developed a vergence-based calculation scheme to derive the REF and gain or loss in ΔM on implantation of a PIOL having power PIOLP. The calculation concept is based on either a thick or thin lens model for the cornea and the PIOL. In a Monte-Carlo simulation considering, all PIOL steps listed in the US patent 5,913,898, nonlinear regression models for REF and ΔM were defined for each PIOL datapoint. Results The calculation shows that simplifying the PIOL to a thin lens could cause some inaccuracies in REF (up to ½ dpt) and ΔM for PIOLs with high positive power. The full range of listed ICL powers (− 17 to 17 dpt) could correct REF in a range from − 17 to 12 dpt with a change in ΔM from 17 to − 25%. The linear regression considering anterior segment biometric data and the PIOLP was not capable of properly characterizing REF and ΔM, whereas the nonlinear model with a quadratic term for the PIOLP showed a good performance for both REF and ΔM prediction. Conclusion Where PIOL design data are available, the calculation concept should consider the PIOL as thick lens model. For daily use, a nonlinear regression model can properly predict REF and ΔM for the entire range of PIOL steps if a vergence calculation is unavailable.

show abstract

Analysis of vault prediction in phakic implantable phakic collamer lenses: manufacturer’s calculator vs theoretical formulae vs clinical practice

Cited by 4 publications

References 20 publications

Implantable Collamer Lens Procedure Planning: A Review of Global Approaches

Implantable Collamer Lens Procedure Planning: A Review of Global Approaches

Clinical decision support system based on deep learning for evaluating implantable collamer lens size and vault after implantable collamer lens surgery: a retrospective study

Monte-Carlo simulation for calculating phakic supplementary lenses based on a thick and thin lens model using anterior segment OCT data

Contact Info

Product

Resources

About