PurposeTo investigate the change in the vault of the implantable collamer lens (ICL) under dark-to-light conditions and its association with anterior chamber and lens parameters in patients undergoing ICL surgery.MethodsIn 76 eyes from 40 patients, preoperative anterior chamber volume (ACV), pupil diameter (PD), anterior chamber angle, central corneal thickness (CCT), white-to-white (WTW), lens thickness (LT), axial length (AL), spherical equivalent (SE) and patient's age were collected. Postoperative vault, PD and LT were measured under dark and light conditions using anterior segment optical coherence tomography (CASIA2; TOMEY, Japan), and changes and lens displacement under dark-to-light conditions were calculated. Mixed-effects models were used to analyze the correlation between the vault change and the anterior chamber and lens parameters of all subjects and the high-vault subgroup.ResultsThe vault under light condition (648.36 ± 304.47 μm) was significantly smaller compared to the vault under dark condition (708.89 ± 316.15 μm). In all patients, vault change increased with the increase of age, lens displacement and PD change; and increased with the decrease of ACV, LT change and baseline vault (under dark condition). In the high-vault subgroup, vault change increased with the increase of CCT, lens displacement and PD change; and increased with the decrease of ACV.ConclusionsICL vault changes significantly from dark to light, influenced by age, ACV, PD change, LT change, lens displacement, and baseline vault. A higher baseline vault is correlated with a larger LT change, affecting the levels of accommodation under dark-to-light transition.