ICL vault describes the space between the back surface of the ICL and the front of the natural crystalline lens. Although measured in hundreds of microns, this distance plays a major role in long-term safety.
If vault is too low, prolonged contact or proximity to the natural lens increases the risk of anterior subcapsular cataract formation. If vault is too high, it can contribute to angle crowding or elevated intraocular pressure. ¹ The goal is a balanced vault that allows healthy aqueous flow while protecting sensitive structures.
Vault is influenced by individual anatomy and ICL sizing and cannot be sensed by the patient. Imaging tools such as anterior segment OCT or ultrasound biomicroscopy are therefore used during follow-up. ¹
Vault can change gradually over time as the natural lens thickens with age, particularly in patients entering their 40s. ² Ongoing monitoring allows clinicians to distinguish normal anatomical change from early signs that further action, whether observation, adjustment, or future lens surgery, may need discussion.
References
- Kamiya K, Shimizu K, Igarashi A, Komatsu M. Changes in vaulting and the effect on refraction after phakic posterior chamber intraocular lens implantation. J Cataract Refract Surg. 2009;35(9):1582–1586.
- Kamiya K, Shimizu K, Kobashi H, Igarashi A, Komatsu M. Long-term changes in vault after posterior chamber phakic intraocular lens implantation. Ophthalmology. 2015;122(1):145–152.
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