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Biometric Factors Affecting Vaulting After Intraocular Collamer Lens Implantation.

Biometric Factors Affecting Vaulting After Intraocular Collamer Lens Implantation. David Sung Yong Kang 1,2 , Jin Young Choi 1 , Hun Yang 1 , Ik Hee Ryu 1 , Hee Sun Kim 1 , Seong Bae Park 1 , Jin Kuk Kim 1 and Chan Yun Kim 2 .

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Biometric Factors Affecting Vaulting After Intraocular Collamer Lens Implantation.

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  1. Biometric Factors Affecting Vaulting After Intraocular Collamer Lens Implantation. David Sung Yong Kang1,2, Jin Young Choi1, Hun Yang1, IkHeeRyu1, Hee Sun Kim1, SeongBae Park1, Jin Kuk Kim1 and Chan Yun Kim2. 1. Clean Vision Eye Center, GangNam, Seoul, Korea. 2. Yonsei University College of Medicine, Seoul, Korea. The Authors have No Financial Interest in the Subject Matter of this Poster.

  2. OBJECTIVES 1. To Evaluate Pre-operative Biometrics Predictive of Final ICL Vaulting. 2. To Evaluate Manufacturer Recommendation Lens Size on Final ICL Vault Outcome.

  3. METHODS Retrospective Observational Non-Interventional Case Series Duration: 2009.9 – 2010. 4 At Least 6 months F/U Participants: 133 Eyes of 67 pts Implanted with 120 sized V4 Intraocular Collamer Lens (ICL, Starr Surgical).

  4. METHODS Pre-Op. Biometric Evaluation: 1. Corneal White-to-White(WTW): Keratograph(70600, Oculus) 2. Anterior Chamber Depth (ACD) Measurement: A-Scan (SP-3000,Tomey,Japan) 3. Sulcus-to-SulcusMeasurement(STS): Ultrasound Bio-Microscopy(UBM,Aviso,Quantel Medical) 4. Angle-to-Angle(ATA) Measurement, Angle Parameters (AOD, TISA 500 & 750) Anterior Segment Optical Coherence Tomography (OCT): (Visante OCT, Carl ZeissMeditech, Dublin,CA) 5. Anterior Chamber Volume Assessment: Pentacam(Oculus) Post-Op. Biometric Evaluation: ICL Vaulting Angle Parameters (AOD & TISA 500 & 750) All by Visante OCT.

  5. METHODS Exclusion Criteria V: Vaulting, PI:Laser Peripheral Iridotomy, OHTN: Ocular Hypertension, F/U: Follow up

  6. METHODS High Vault: >750 Microns Optimal Vault:250 – 550 Microns Low Vault: <250 Microns Evaluated at POD # 6 Months With Anterior Segment OCT

  7. RESULTS The t-test Procedure; SPSS Ver12.0; p<0.05 considered Siginificant

  8. Specificities at Fixed Sensitivities Optimal vs High Vaulters WTW: White-to-white(mm), STS: Sulcus-to-Sulcus(mm), ATA: Angle-to-Angle(mm) Optimal vs Low Vaulters WTW: White-to-white(mm), ACD: Anterior Chamber Depth(mm), ACV: Anterior Chamber Volume(mm3)

  9. Combination of Specificities: vs High Vaulters (Sensitivity > 80%) 83.6% 88.4% 90% 86.7% Frequency Proportion Analysis (WTW, STS and ATA; all in mm)

  10. Combination of Specificities: vs Low Vaulters (Sensitivity > 80%) 92.5% 91% 93.4% 94.2% Frequency Proportion Analysis (WTW, ACD and ACV; mm and mm3)

  11. VS Manufacturer Recommendations (#Manufacturer Recommendations for All ICLs that were Finally Implanted with 120 Sized S4 ICL)

  12. CONCLUSIONS Age, ACD, ACV and WTW were significant factors in predicting Post-op Low Vaulters. A Combination of these Factors Raised Predictability to 93.4%. 2. STS, ATA and WTW were Significant Factors in Predicting Post-op High Vaulters. A Combination of these Factors Raised Predictability to 90%. 3.Current Paradigm of Relying on ACD, WTW and STS may need to be Revised in Asian Eyes. 4. Manufacturer Guidelines cannot be Infallible in Predicting Ideal Vaulting, especially In Asian Eyes.

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