1. David Sung Yong Kang 1,2, Jin Young Choi 1, Hun Yang 1, Ik Hee Ryu 1, Hee Sun Kim 1, Seong Bae Park 1, Jin Kuk Kim 1 and Chan Yun Kim 2. 1. Clean Vision Eye Center, GangNam, Seoul, Korea. 2. Yonsei University College of Medicine, Seoul, Korea. The Authors have No Financial Interest in the Subject Matter of this Poster.

2.  1. To Evaluate Pre-operative Biometrics Predictive of Final ICL Vaulting.  2. To Evaluate Manufacturer Recommendation Lens Size on Final ICL Vault Outcome.

3.  Retrospective Observational Non-Interventional Case Series  Duration: 2009.9 – 2010. 4 At Least 6 months F/U  Participants: 133 Eyes of 67 pts Implanted with 120 sized V4 Intraocular Collamer Lens (ICL, Starr Surgical).

4. Pre-Op. Biometric Evaluation: 1. Corneal White-to-White(WTW): Keratograph (70600, Oculus) 2. Anterior Chamber Depth (ACD) Measurement: A-Scan (SP-3000,Tomey,Japan) 3. Sulcus-to-Sulcus Measurement(STS): Ultrasound Bio-Microscopy (UBM,Aviso,Quantel Medical) 4. Angle-to-Angle(ATA) Measurement, Angle Parameters (AOD, TISA 500 & 750) Anterior Segment Optical Coherence Tomography (OCT): (Visante OCT, Carl Zeiss Meditech, Dublin,CA) 5. Anterior Chamber Volume Assessment: Pentacam (Oculus) Post-Op. Biometric Evaluation: 1.ICL Vaulting 2.Angle Parameters (AOD & TISA 500 & 750) All by Visante OCT.

5. No. of EyesReasonMeasuresPOD # Weeks 2High VExchanged# 1 & 3 2Low VExchanged# 4 2Non-Patent PI High V Further PI# 2 & 3 5Steroid Induced OHTN Anti-HTN Medication 1F/U Loss Final Inclusion 121 Exclusion Criteria V: Vaulting, PI:Laser Peripheral Iridotomy, OHTN: Ocular Hypertension, F/U: Follow up

6. High Vault: >750 Microns Optimal Vault:250 – 550 Microns Low Vault: <250 Microns Evaluated at POD # 6 Months With Anterior Segment OCT

7. RESULTS The t-test Procedure; SPSS Ver12.0; p<0.05 considered Siginificant

8. Optimal vs High Vaulters Optimal vs Low Vaulters WTW: White-to-white(mm), STS: Sulcus-to-Sulcus(mm), ATA: Angle-to-Angle(mm) WTW: White-to-white(mm), ACD: Anterior Chamber Depth(mm), ACV: Anterior Chamber Volume(mm3)

9. WTW(>11.65) ATA(>11.895) STS(>11.56) 90% (Sensitivity > 80%) Frequency Proportion Analysis 88.4% 83.6% 86.7% (WTW, STS and ATA; all in mm)

10. WTW(>11.65) ACV(>188.5) ACD(>3.13) 93.4 % 92.5%91% 94.2% Frequency Proportion Analysis (WTW, ACD and ACV; mm and mm3) (Sensitivity > 80%)

11. (#Manufacturer Recommendations for All ICLs that were Finally Implanted with 120 Sized S4 ICL)

12. 1.Age, ACD, ACV and WTW were significant factors in predicting Post-op Low Vaulters. A Combination of these Factors Raised Predictability to 93.4%. 2. STS, ATA and WTW were Significant Factors in Predicting Post-op High Vaulters. A Combination of these Factors Raised Predictability to 90%. 3.Current Paradigm of Relying on ACD, WTW and STS may need to be Revised in Asian Eyes. 4. Manufacturer Guidelines cannot be Infallible in Predicting Ideal Vaulting, especially In Asian Eyes.