Phacoemulsification in eyes with extreme axial myopia

• Published in: Journal of cataract and refractive surgery Vol. 35; no. 2; pp. 335 - 340
• Main Authors: Zuberbuhler, Bruno, MD, Seyedian, Mohammad, MD, Tuft, Stephen, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2009; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cataract - complications; Eye - pathology; Female; Humans; Intraoperative Complications; Lens Implantation, Intraocular; Male; Medical sciences; Middle Aged; Myopia, Degenerative - complications; Ophthalmology; Phacoemulsification; Postoperative Complications; Refraction, Ocular - physiology; Retinal Detachment - etiology; Retinal Detachment - surgery; Retrospective Studies; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Treatment Outcome; Vision disorders; Visual Acuity - physiology; Vitrectomy; Young Adult; Eye; Eye disease; Treatment; Vision disorder; Surgery; Refractive error; Myopia; Ophthalmology; Phacoemulsification
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2008.10.044

Purpose To determine the outcomes of phacoemulsification of age-related cataract in eyes with extreme axial myopia. Setting Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Methods This consecutive case series of eyes with an axial length (AL) greater than 30.0 mm was identified retrospectively. Surgical procedure details, complications, and refractive outcome were recorded. The incidence of postoperative retinal detachment (RD) was assessed in a subgroup of eyes without previous RD or vitrectomy. Results One hundred seventy-seven eyes (124 patients) were identified from a dataset of 6882 cataract procedures; 21 eyes had previous RD or vitrectomy. Intraoperative complications were posterior capsule tear (5 eyes, 2.8%), zonular dehiscence (3 eyes, 1.7%), and anterior capsule tear (2 eyes, 1.1%). At a median follow-up of 25.4 months, 2 (1.3%) of 156 eyes without previous RD or vitrectomy developed RD. The median biometry prediction error in the 156 eyes (88.1%) with an intraocular lens (IOL) was 0.88 diopter (D) (range 0.00 to 5.75 D); 83 eyes (53.2%) were within ±1.00 D. The median biometry prediction error was greater in the 61 eyes that received a negative-power IOL (1.38 D) than in the 95 eyes that received a plano or positive-power IOL (0.68 D) ( P <.001). Conclusions The incidence of complications after phacoemulsification in eyes with extreme axial myopia was similar to that in previously reported unselected case series. The refractive outcome showed a hyperopic error that increased with AL, an effect that was primarily the result of the eyes that received a negative-power IOL.