Vertical implantable collamer lens (ICL) rotation for the management of high vault due to lens oversizing
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To describe the good outcome of implantable collamer lens (ICL) rotation to reduce post-operative vault.
Retrospective analysis of case report. A 43-year-old woman had V4c EVO + myopic non-toric ICL implantation and post-operatively she presented with anisocoria and high vault. She underwent surgery to rotate the ICL 90 degrees to a vertical orientation.
We achieved a reduction in the vault from 1020 to 486 μm after vertical ICL rotation. Satisfactory refractive outcome and optimal vault were achieved and maintained during the period of follow-up.
Optimal ICL sizing is important as too high vault/clearance is associated with problems such as angle closure glaucoma, pupil dilatation and anisocoria and too low vault/clearance to increased risk of cataract formation. Non-toric ICL rotation can be a simple surgical technique to deal with oversized lenses thus avoiding ICL exchange.
KeywordsRefractive surgery Phakic intraocular lens Implantable collamer lens High vault
Alex Day was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Compliance with ethical standards
Conflict of interest
Mr. Maurino: Honorarium Instructor for Staar (last in 2015) and remaining authors declare that they have no competing interests.
The patient has consented to the submission of the case report for submission to the journal.
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