Clinical context
Myopia studies should distinguish refractive change from axial elongation. The measures are related but not interchangeable, and their clinical meaning depends on age, baseline myopia and follow-up duration. Studies of progression control should also assess tolerability, adherence, rebound after treatment stops and potential adverse effects.
What was studied
The authors systematically reviewed models and nomograms for implantable collamer lens sizing and postoperative vault prediction. PubMed and Scopus were searched from January 2010 through July 2025, and risk of bias was assessed with PROBAST. Of 675 records identified, 38 studies were included: 20 used AS-OCT and 18 used ultrasound biomicroscopy.
How the evidence was produced
A systematic review is valuable because it uses a transparent search and predefined criteria to assess the available literature. Reliability depends on search completeness, study selection, risk-of-bias assessment and the quality of included evidence. A broad review cannot remove limitations in the primary studies or turn heterogeneous evidence into a universal recommendation.
How to interpret the result
Vault prediction depends on more than the formula itself: device characteristics, measurement protocol, patient mix and surgical practice all influence performance. A non-significant difference between technology groups does not make a particular AS-OCT and UBM nomogram interchangeable. Local validation on the intended equipment and understanding the error distribution are more informative than selecting a method solely from the pooled average.
The result should be understood as an estimate for the population studied, not a promise of an individual outcome. Statistical and clinical significance, absolute and relative effects, and prespecified and exploratory analyses should be distinguished. When several endpoints or subgroups are reported, the prespecified primary endpoint for which the study was designed usually provides the most reliable inference.
Clinical applicability
The findings apply most directly to patients who resemble participants in age, baseline refraction and rate of progression. Before selecting an intervention, check durability, the method used to measure axial length, completeness of follow-up and safety. A group average cannot predict the exact response of an individual child or adult.
Limitations
Studies varied substantially in populations, imaging platforms, target vault ranges and validation strategies. Many prediction models are tested using data from the same center in which they were developed, increasing the risk of optimistic performance estimates. The review found no universal winner; combining several locally validated nomograms may support decisions, but improved clinical outcomes from that strategy have not yet been established.
Beyond the limitations acknowledged by the authors, confidence is affected by sample size, follow-up duration, missing data, choice of comparator and relevance of the outcomes to routine care. Uncommon complications may remain undetected even in a well-conducted study. External validity is reduced when participants, equipment or investigator expertise differ substantially from everyday settings.
What to verify in the source
In the full paper, verify the protocol, eligibility criteria, baseline group characteristics, primary endpoint definition, confidence intervals, adverse events and losses to follow-up. Funding, conflicts of interest, trial registration and consistency between the published analysis and the original plan deserve separate attention. The DOI or source link below provides access to the primary publication for this check.