title: Real-time assessment of intraoperative vaulting in implantable collamer lens and correlation with postoperative vaulting.
abstract: OBJECTIVE
  To assess the intraoperative vaulting in patients undergoing implantable collamer lens (ICL) implantation with microscope-integrated intraoperative optical coherence tomography (iOCT) and correlate it with the postoperative vaulting.
  
  
  METHODS
  Forty eyes of 22 consecutive patients undergoing ICL implantation were prospectively evaluated. Vaulting was measured intraoperatively using microscope-integrated iOCT. The ICL-lenticular relationship was dynamically assessed throughout the surgery. Postoperative vaulting was measured using anterior segment optical coherence tomography on the first postoperative day and after 1 month and compared with the intraoperative vaulting. Uncorrected and best-corrected Snellen visual acuity, intraocular pressure (IOP), and anterior and posterior segments were assessed in all cases.
  
  
  RESULTS
  The mean central vaulting noted intraoperatively was 558.4 ± 122.8 µm. Postoperative mean vaulting was 576.0 ± 131.2 µm on day 1 and 551.1 ± 122.5 µm on day 30. There was a significant correlation between the intraoperative and the postoperative day 1 vaulting (paired samples correlation: 0.969, p&lt;0.001) and day 30 vaulting (paired samples correlation: 0.945, p&lt;0.001). An ICL-lenticular touch was not noted at any time during the surgery. The postoperative course was uneventful and no patient developed raised IOP or lenticular changes by the last follow-up.
  
  
  CONCLUSIONS
  Intraoperative vaulting correlates well with postoperative vaulting and can aid in on-table detection of extremes of vaulting and decision-making. It enhances the safety of the surgical procedure by providing a real-time display of the intraoperative manipulations.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Manpreet
authors.initials: M
authors.lastname: Kaur
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Suman
authors.initials: S
authors.lastname: Sahu
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sinha
mesh_terms: D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications / Q000175:diagnosis; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline; D008297:Male; D009216:Myopia / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult