Clear lens extraction for the correction of high myopia

• Published in: Ophthalmology (Rochester, Minn.) Vol. 110; no. 12; pp. 2349 - 2354
• Main Authors: Fernández-Vega, Luis, Alfonso, José F, Villacampa, Tomás
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2003; Elsevier
• Subjects: Adult; Biological and medical sciences; Contrast Sensitivity; Diseases of the eye; Female; Follow-Up Studies; Humans; Intraoperative Complications; Lens Implantation, Intraocular; Lens, Crystalline - surgery; Male; Medical sciences; Middle Aged; Myopia - surgery; Ophthalmology; Postoperative Complications; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Treatment Outcome; Vision disorders; Visual Acuity; Human; Prognosis; Vision disorder; Myopia; Implantation; Eye disease; Treatment; Surgery; Refractive error; Complication; Lens; Extraction; Posterior chamber; Severe; Intraocular lens; Corrections
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/S0161-6420(03)00794-2

To evaluate the postoperative outcomes and intraoperative and postoperative complications of clear lens extraction (CLE) with posterior chamber intraocular lens (IOL) implantation in highly myopic eyes. Retrospective case series. One hundred seven patients (190 eyes) who had undergone CLE with posterior chamber IOL implantation and who had been observed for at least 3 years after surgery. Medical records of patients who had undergone CLE with posterior chamber IOL implantation to treat high myopia (axial length >26.00 mm) over 7 years (January 1990 to December 1996) were reviewed. Visual acuity and refractive error were assessed before and after surgery, and perioperative, intraoperative, and postoperative complications were recorded. Axial length, preoperative and final best spectacle-corrected visual acuity (BSCVA), preoperative and postoperative spherical equivalent (SE), argon laser treatments, surgical complications, neodymium:yttrium–aluminum–garnet (Nd:YAG) laser capsulotomy, retinal detachment (RD), time from surgery or Nd:YAG capsulotomy to RD, subfoveal choroidal neovascularization (CNV), and follow-up period. The mean postoperative follow-up period was 4.78 years (range, 3.10–8.03 years). Final BSCVA was better than preoperative BSCVA in 159 eyes (83.68%), equal in 24 eyes (12.63%), and worse in 7 eyes (3.68%). Postoperative BSCVA was 20/40 or better in 136 eyes (71.60%) vs. 52 eyes (27.36%) before surgery ( P<0.001). The mean final postoperative SE was −1.22 diopters. The risk of Nd:YAG laser capsulotomy was 77.89%. The incidence of RD was 2.10%; retinal reattachment was achieved in all cases, and none of these eyes had worse final BSCVA than before surgery. Subfoveal CNV developed in 4 eyes (2.10%) of 3 patients; all of these eyes presented with a macular lacquer crack. Clear lens extraction with posterior chamber IOL implantation has good outcomes with acceptable predictability and improvement in best-corrected visual acuity. During follow-up, patients tended to remain stable, and the risk of retinal detachment was low. We attribute our favorable results to careful patient selection and follow-up.