High myopes fare well after modern cataract surgery

Although studies in the literature report that high myopes undergoing cataract surgery are at increased risk for posterior capsule rupture and have poorer refractive outcomes than average eyes, a retrospective study based on a large consecutive case series from Moorfields Eye Hospital, London, UK, generated favorable results.

The series included 407 eyes with an axial length of at least 26 mm (mean 27.81 mm). About 9% of surgeries were done by trainees.

Gianluca Carifi, MD, reported on perioperative complications with a focus on posterior capsule events. Overall, there were 19 (4.67%) complications, including 7 (1.72%) posterior capsule events. There were also 7 eyes with an anterior capsule tear.

“Our rate of posterior capsule complications in eyes with long axial length is similar to that previously described in a large dataset. Unexpectedly, however, we found a relatively high rate of anterior capsule tear in these eyes that have a normal to deep anterior chamber depth,” Dr. Carifi said.

Vasiliki Zygoura, MD, presented the findings from an analysis of refractive outcomes. After excluding cases that had secondary IOL implantation, previous corneal or refractive surgery, corneal disease affecting keratometry measurement, or intraoperative or chronic postoperative complication, data were included for 315 eyes. The achieved refraction in the latter cohort was within 0.5 D of target in 63.5% of eyes and within 1.0 D in 89.5%, and the results were similar comparing eyes implanted with a single-piece versus a multi-piece IOL.

Dr. Zygoura compared the outcomes with those reported by Olsen et al. in an unselected series of cases. She said, “The refractive outcomes following modern cataract surgery in our population of high myopes seem to be in line with those of the general population.”