LAUSR

PURPOSE To assess the use of intraoperative optical coherence tomography (OCT) to detect high vault during implantation surgery and guide intraoperative vault adjustment by ICL rotation. SETTING Instituto Zaldivar SA. Mendoza, Argentina. DESIGN Prospective, single-arm, observational study. METHODS A total of 25 eyes of 25 consecutive patients showing high intraoperative vault who undergone Implantable Collamer Lens (ICL) rotation from horizontal to vertical or oblique position were evaluated. Central ICL vault was measured both intraoperatively using the microscope-integrated iOCT (Optomedical Technologies GmbH, Luebeck, Germany, merged with Haag-Streit Surgical GmbH & Co. KG in May 2020) mounted on a standard surgical microscope (HS Hi-R NEO 900A NIR, Haag-Streit Surgical GmbH & Co. KG, Wedel, Germany), and postoperatively using the Casia 2 swept-source OCT (Tomey GmbH, Nürnberg, Germany) at 4 hours, 1 day and 1 month. RESULTS Mean vault value obtained intraoperatively was 1147.88±188.36 μm and changed significantly to 739.76 ± 194.97 μm after lens rotation to either vertical (n=19, 76% of cases) or oblique (n=6, 24% of cases) positions (mean difference 408.12 ± 213.57 μm, p < 0.001). There was significant relationship between the amount of change due to lens rotation with white-to-white distance (r=-0.480, p=0.015) and vault before rotation (r=-0.564, p=0.003). Mean vault values were 758.40±187.10 μm, 729.73±227.86 μm and 661.88±275.17 μm at 4 hours, 24 hours and 1-month post-surgery, respectively. CONCLUSIONS Intraoperative adjustment of ICL vault by lens rotation using intraoperative OCT is an effective procedure to obtain an optimal vault.