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ICL Sizing Research & Publications

ICL Fit is built by the refractive-surgery and machine-learning team behind VAULT and VAULT-OCT — the peer-reviewed, deep-learning approach to predicting ICL vault from anterior-segment imaging. Below is the published research behind the tool.

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Peer-reviewed publications

Traditional ICL sizing relies on white-to-white measurement and a manufacturer nomogram, which only approximate the sulcus geometry that actually governs vault. The ICL Fit team's published work — including the VAULT and VAULT-OCT deep-learning models — trains on preoperative anterior-segment imaging paired with measured post-operative vault, with the goal of reducing vault-related ICL exchanges and improving predictability. ICL Fit brings that approach to Pentacam-based sizing for everyday clinical use.

  • Hirabayashi M, Cantu E, Abramson A, Virdi G, Nasser T, Parkhurst G. Dynamic Changes in Implantable Collamer Lens Vault and Anterior Chamber Angle Under Varying Lighting Conditions. Clinical Ophthalmology. April 2026. https://doi.org/10.2147/OPTH.S603534
  • Hirabayashi M, Virdi G, Nasser T, Abramson A, Parkhurst G. VAULT-OCT: Vault Accuracy Using Deep Learning Technology for Predicting ICL Postoperative Vault with Anterior Segment Optical Coherence Tomography. Journal of Cataract & Refractive Surgery. July 2025. https://doi.org/10.1097/j.jcrs.0000000000001743
  • Hirabayashi M, Virdi G, Nasser T, Abramson A, Parkhurst G. Accuracy of Reported Sizes of the EVO/EVO+ Visian Implantable Collamer Lenses. Cureus. August 2025. https://doi.org/10.7759/cureus.90468
  • Hirabayashi M, Virdi G, Nasser T, Libfraind L, Zapata E, Abramson A, Parkhurst G. ICL Exchanges or Explants Due to Sizing in a United States High Volume Center. Clinical Ophthalmology. July 2025. https://doi.org/10.2147/OPTH.S528280
  • Hirabayashi M, Virdi G, Abramson A, Nasser T, Vanrachack A, Parkhurst G. Clinical Outcomes of Implantable Collamer Lenses for the Treatment of Myopia in Eyes with Anterior Chamber Depth (<3.0 mm) at a Single Center in the United States. Clinical Ophthalmology. 2025. https://doi.org/10.2147/OPTH.S528267
  • Nasser T, Hirabayashi M, Virdi G, Abramson A, Parkhurst G. VAULT: Vault Accuracy Using Deep Learning Technology — A Novel Image-Based AI Model for Predicting Implantable Collamer Lens Postoperative Vault. Journal of Cataract & Refractive Surgery. April 2024. https://doi.org/10.1097/j.jcrs.0000000000001386
  • Hirabayashi M, Cooley A, Shakarchi F, Vanrachack A, Ducker L, Shelby C, Coleman W, Parkhurst G, LoBue S. Phakic Intraocular Lenses as a Potential Treatment for Pigment Dispersion Syndrome. Cureus. February 2026. https://doi.org/10.7759/cureus.108051

Selected presentations

  • Virdi G. ICL Sizing Using Multiple AI-Based Modalities. Presented at American-European Congress of Ophthalmic Surgery (AECOS) Summer Symposium. 2026.
  • Hirabayashi M, Virdi G, Nasser T, Abramson A, Parkhurst G. VAULT-OCT: Vault Accuracy Using Deep Learning Technology for Predicting ICL Postoperative Vault with AS-OCT. Presented at American Society of Cataract and Refractive Surgery (ASCRS). 2024.
  • Virdi G, Hirabayashi M, Nasser T, Parkhurst G. The Future of AI ICL Sizing is OCT, Not UBM. Presented at STAAR Surgeon Summit. 2024.
  • Virdi G, Hirabayashi M, Nasser T, Parkhurst G. VAULT-OCT: Deep Learning to Predict ICL Vault from OCT. Presented at YMDC Live. 2025.

The team

ICL Fit is developed by a team including Matt Hirabayashi, MD (co-founder of ICL Fit), Gurpal Virdi, MD, Taj Nasser, MD, and Gregory Parkhurst, MD — refractive surgeons and researchers who developed the VAULT and VAULT-OCT deep-learning vault-prediction models, published in the Journal of Cataract & Refractive Surgery, Clinical Ophthalmology, and Cureus. Several are also co-founders of Refractive Foundations, whose free EVO ICL Workshop covers sizing, power selection, and off-label use.

Learn more

Read the ICL sizing FAQ, the ICL Education overview, or the plain-language guide for patients.