ArticleBMC ophthalmology2026
Quantitative analysis of the effect of ICL orientation on postoperative vault: a self-controlled retrospective study.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo investigate the effect of ICL implantation orientation on the postoperative vault quantitatively.
methodsA total of 3510 eyes from 2042 subjects who underwent ICL implantation between July 1, 2020, and June 30, 2023, were included in this self-controlled retrospective study. We selected all subjects with nonhorizontal placement in the second surgical eye and divided them into four groups: same-sized vertical placement (group A), larger-sized vertical placement (group B), same-sized oblique placement (group C), and larger-sized oblique placement (group D). The achieved and predicted vaults were compared in each group.
resultsA total of 126, 81, 82 and 11 subjects were included in groups A, B, C and D, respectively. The mean difference in vault between fellow eyes in groups A, B, C and D was − 284.79 ± 169.92 μm, 53.59 ± 136.06 μm, -107.30 ± 136.09 μm and 208.18 ± 118.64 μm, respectively, and all the differences were statistically significant (P < 0.001, P = 0.001, P < 0.001, P < 0.001). The mean differences between the achieved and predicted vaults of the horizontal-placement eyes in groups A, B, C and D were 23.14 ± 233.20 μm, -46.39 ± 189.22 μm, 9.45 ± 187.43 μm, and − 76.72 ± 165.68 μm, respectively, and for the nonhorizontal-placement eyes, the achieved vault of subjects in groups A, B, C and D were 294.59 ± 181.72 μm, 313.22 ± 226.52 μm, 110.02 ± 177.67 μm and 191.63 ± 257.78 μm lower than the predicted vault; all the differences were statistically significant (all P < 0.05). In groups A and C, the difference in vault between horizontal and nonhorizontal ICL placement was significantly correlated with the vault of the first surgical eye (P < 0.001).
conclusionsVertical or oblique implantation can safely fine-tune vault without exchanging the lens, especially when the first-eye vault is excessive. These within-subject estimates provide immediately applicable guidance for intra-operative orientation selection.
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