VAULT: vault accuracy using deep learning technology: new image-based artificial intelligence model for predicting implantable collamer lens postoperative vault

Purpose: To develop an accurate deep learning model to predict postoperative vault of phakic implantable collamer lenses (ICLs). Setting: Parkhurst NuVision LASIK Eye Surgery, San Antonio, Texas. Design: Retrospective machine learning study. Methods: 437 eyes of 221 consecutive patients who underwent ICL implantation were included. A neural network was trained on preoperative very high–frequency digital ultrasound images, patient demographics, and postoperative vault. Results: 3059 images from 437 eyes of 221 patients were used to train the algorithm on individual ICL sizes. The 13.7 mm size was excluded because of insufficient data. A mean absolute error of 66.3 μm, 103 μm, and 91.8 μm were achieved with 100%, 99.0%, and 96.6% of predictions within 500 μm for the 12.1 mm, 12.6 mm, and 13.2 mm sizes, respectively. Conclusions: This deep learning model achieved a high level of accuracy of predicting postoperative ICL vault with the overwhelming majority of predictions successfully within a clinically acceptable margin of vault.