Tianyu Zheng1, Zhanghua Chen2, Jie Xu1, Yating Tang1, Qi Fan1, Yi Lu3. 1. Department of Ophthalmology and Eye Institute, EYE and ENT Hospital of Fudan University and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China. 2. Southern California Environmental Health Sciences Center, Department of Preventive Medicine, University of Southern California, Los Angeles, California. 3. Department of Ophthalmology and Eye Institute, EYE and ENT Hospital of Fudan University and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China. Electronic address: luyieent@126.com.
Abstract
PURPOSE: To study the long-term visual outcomes, complications, and prognostic factors for cataract surgery in extreme microphthalmos. DESIGN: Prospective cohort study. METHODS: Thirty eyes with simple microphthalmos (11 eyes, axial length [AL] <18 mm), complex microphthalmos (8 eyes, AL <18 mm), and relative anterior microphthalmos (RAM; 11 eyes, corneal diameter [CD] <8 mm) who underwent cataract surgery (phacoemulsification) in our hospital were followed for a mean of 25.3 months with at least 3 visits at early (1 day to 1 week), mid (1-3 months), and late (>6 months) stages after surgery. The main outcome measures included the best-corrected visual acuity (BCVA), intraocular pressure (IOP), and complications. RESULTS: Significant improvements of BCVA were observed at the mid and late postoperative visits in the entire cohort when compared with preoperative value (P < .05). When eyes were divided into 3 groups, a statistically significant improvement in late-stage BCVA was observed in the simple microphthalmos and RAM groups. The AL, preoperative anterior chamber depth (ACD), and preoperative BCVA were significant prognostic factors for late-stage BCVA after surgery. The most common complications were early corneal edema (73%), glaucoma (33%), and posterior capsular opacification (23%). Preoperative ACD was significantly associated with the incidence of glaucoma after surgery (P < .05). Severe complications included suprachoroidal hemorrhage (3%), endothelial dysfunction (7%), and retinal detachment (7%). CONCLUSIONS: Cataract surgery provided visual improvement in extreme microphthalmos (simple microphthalmos and RAM), with higher risks of complications than with routine cataract surgeries. Extreme microphthalmos with preoperative characteristics of relatively longer AL, deeper ACD, and better BCVA may benefit more from cataract surgery.
PURPOSE: To study the long-term visual outcomes, complications, and prognostic factors for cataract surgery in extreme microphthalmos. DESIGN: Prospective cohort study. METHODS: Thirty eyes with simple microphthalmos (11 eyes, axial length [AL] <18 mm), complex microphthalmos (8 eyes, AL <18 mm), and relative anterior microphthalmos (RAM; 11 eyes, corneal diameter [CD] <8 mm) who underwent cataract surgery (phacoemulsification) in our hospital were followed for a mean of 25.3 months with at least 3 visits at early (1 day to 1 week), mid (1-3 months), and late (>6 months) stages after surgery. The main outcome measures included the best-corrected visual acuity (BCVA), intraocular pressure (IOP), and complications. RESULTS: Significant improvements of BCVA were observed at the mid and late postoperative visits in the entire cohort when compared with preoperative value (P < .05). When eyes were divided into 3 groups, a statistically significant improvement in late-stage BCVA was observed in the simple microphthalmos and RAM groups. The AL, preoperative anterior chamber depth (ACD), and preoperative BCVA were significant prognostic factors for late-stage BCVA after surgery. The most common complications were early corneal edema (73%), glaucoma (33%), and posterior capsular opacification (23%). Preoperative ACD was significantly associated with the incidence of glaucoma after surgery (P < .05). Severe complications included suprachoroidal hemorrhage (3%), endothelial dysfunction (7%), and retinal detachment (7%). CONCLUSIONS:Cataract surgery provided visual improvement in extreme microphthalmos (simple microphthalmos and RAM), with higher risks of complications than with routine cataract surgeries. Extreme microphthalmos with preoperative characteristics of relatively longer AL, deeper ACD, and better BCVA may benefit more from cataract surgery.