International Ophthalmology

, Volume 38, Issue 6, pp 2689–2692 | Cite as

Vertical implantable collamer lens (ICL) rotation for the management of high vault due to lens oversizing

  • Francesco Matarazzo
  • Alexander Clifford Day
  • Luis Fernandez-Vega Cueto
  • Vincenzo Maurino
Case Report



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.


Refractive 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.

Informed consent

The patient has consented to the submission of the case report for submission to the journal.


  1. 1.
    Sanders DR, Doney K, Poco M, ICL in Treatment of Myopia Study Group (2004) United States food and drug administration clinical trial of the implantable collamer lens (ICL) for moderate to high myopia: 3-year follow-up. Ophthalmology 111(9):1683–1692. CrossRefPubMedGoogle Scholar
  2. 2.
    Packer M (2016) Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol 9(10):1059–1077. CrossRefGoogle Scholar
  3. 3.
    AlSabaani NA, Behrens A, Jastanieah S, Al Malki S, Al Jindan M, Al Motowa S (2016) Causes of phakic implantable collamer lens explantation/exchange at king Khaled eye specialist hospital. Middle East Afr J Ophthalmol 23(4):293–295. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Reinstein DZ, Archer TJ, Silverman RH, Rondeau MJ, Coleman DJ (2009) Correlation of anterior chamber angle and ciliary sulcus diameters with white-to-white corneal diameter in high myopes using Artemis VHF digital ultrasound. J Refract Surg 25(2):185–194PubMedPubMedCentralGoogle Scholar
  5. 5.
    Oh J, Shin H-H, Kim J-H, Kim H-M, Song J-S (2007) Direct measurement of the ciliary sulcus diameter by 35-megahertz ultrasound biomicroscopy. Ophthalmology 114(9):1685–1688. CrossRefPubMedGoogle Scholar
  6. 6.
    Biermann J, Bredow L, Boehringer D, Reinhard T (2011) Evaluation of ciliary sulcus diameter using ultrasound biomicroscopy in emmetropic eyes and myopic eyes. J Cataract Refract Surg 37(9):1686–1693. CrossRefPubMedGoogle Scholar
  7. 7.
    Sanders DR, Vukich JA, Doney K, Gaston M, Implantable Contact Lens in Treatment of Myopia Study Group (2003) U.S. Food and drug administration clinical trial of the implantable contact lens for moderate to high myopia. Ophthalmology 110(2):255–266CrossRefGoogle Scholar
  8. 8.
    Zeng Q-Y, Xie X-L, Chen Q (2015) Prevention and management of collagen copolymer phakic intraocular lens exchange: causes and surgical techniques. J Cataract Refract Surg 41(3):576–584. CrossRefPubMedGoogle Scholar
  9. 9.
    Gao J, Liao RF, Li N (2013) Ciliary sulcus diameters at different anterior chamber depths in highly myopic eyes. J Cataract Refract Surg 39(7):1011–1016. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Francesco Matarazzo
    • 1
  • Alexander Clifford Day
    • 1
    • 2
  • Luis Fernandez-Vega Cueto
    • 1
    • 3
  • Vincenzo Maurino
    • 1
  1. 1.Moorfields Eye HospitalLondonUK
  2. 2.The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation TrustUCL Institute of OphthalmologyLondonUK
  3. 3.Fernández-Vega Ophthalmological InstituteOviedoSpain

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