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All the phakic intraocular lenses and ICL are used to correct the myopia, farsightedness and astigmatism and are implanted in the eye without the need to remove the crystalline. These lenses are an excellent alternative for those patients who cannot undergo a laser refractive surgery And, among its advantages, it stands out that they offer a much faster recovery. 

For the implantation of phakic intraocular lenses to be successful, the most suitable vault must be obtained after implantation. What is vault and why is it so important? This and much more we explain below in Área Oftalmológica Avanzada. 

Vault

What is the Vault?

Phakic intraocular lenses are an excellent option to correct refractive defects in patients who are not candidates for surgery with laser technology. These lenses offer many advantages such as rapid visual recovery, high efficiency, stable visual quality, preservation of visual accommodation, and reversibility of surgery.  

Phakic intraocular lens implantation is a very safe and predictable procedure. However, success in refractive surgery with the implantation of these lenses depends, among other factors, on achieving an adequate vault after implantation. The vault is the distance between the posterior face of the intraocular lens and the anterior face of the lens. The ideal is to achieve a vault between 250 and 750 μm.

Because it is important?

Now that you know what the vault is, you must be wondering why the distance between the crystalloid and the lens is so important, or what can happen if the vault is not the most suitable. 

If vault is less than the proper values the patient is at risk of developing anterior subcapsular cataracts after implantation due to direct contact between the intraocular lens and the lens. 

Un very high vault is associated with angle-closure glaucoma by mechanism of a non-pupillary block. The glaucoma angle closure is a medical emergency that must be attended to avoid irreversible damage to the optic nerve and subsequent irreversible loss of vision. 

Why is the vault so important? Because getting a suitable vault is the key to avoid complications after surgery with implantation of phakic intraocular lenses. 

Vault Values

The ideal distance that should exist between the phakic intraocular lens and the lens ranges from 250 to 750 μm.

What to do when it's too high or too low?

Getting the right vault is very important, but the reality is that this goal is not always achieved. If the vault is very low or very high then it will be necessary to remove the intraocular lens and replace it with another one. However, removing a phakic intraocular lens is a delicate process and increases the risk of the patient developing endophthalmitis or injuries to the cornea or the lens. 

However, there are currently softwares that help determine the correct size that the intraocular lens should have according to the horizontal diameter of the cornea, the depth of the anterior chamber and other indicators such as the patient's age, lens power, distance to the rear vertex and keratometry. In this way, the risk of having a vault outside the normal values ​​is reduced considerably.

Summary
Vault
Article name
Vault
Description
Phakic intraocular lenses are an excellent option to correct refractive defects in patients who are not candidates for surgery with laser technology.
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Name of the editor
Área Oftalmológica Avanzada
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Synonyms:
Evaluation by ultrabiomicroscopy, phakic inocular lenses
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