Lei Cai1,2,3, Zhongcui Sun1,2,3, Diwen Guo4, Qi Fan1,2,3, Xiangjia Zhu1,2,3, Jin Yang5,6,7, Yi Lu8,9,10. 1. Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, 200031, Shanghai, China. 2. Key NHC Key Laboratory of Mopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, 200031, Shanghai, China. 3. Shanghai Key Laboratory of Visual Impairment and Restoration, 200031, Shanghai, China. 4. Department of Ophthalmology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, 1111 Xianxia Road, 200336, Shanghai, China. 5. Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, 200031, Shanghai, China. jin_er76@hotmail.com. 6. Key NHC Key Laboratory of Mopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, 200031, Shanghai, China. jin_er76@hotmail.com. 7. Shanghai Key Laboratory of Visual Impairment and Restoration, 200031, Shanghai, China. jin_er76@hotmail.com. 8. Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, 200031, Shanghai, China. luyieent@126.com. 9. Key NHC Key Laboratory of Mopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, 200031, Shanghai, China. luyieent@126.com. 10. Shanghai Key Laboratory of Visual Impairment and Restoration, 200031, Shanghai, China. luyieent@126.com.
Abstract
PURPOSE: To evaluate the long-term effect of cataract surgery on highly myopic patients with myopic traction maculopathy (MTM) and the risk factors associated with MTM progression. METHODS: Highly myopic patients with cataract and MTM were included. Phacoemulsification surgery was performed on patients who had vision loss below 20/63 and were willing to operation. Exclusion criteria included full thickness macular hole, foveal/retinal detachment, history of vitreoretinal surgery, myopic choroidal neovascularization, macular chorioretinal atrophy, peripheral lattice degeneration, incomplete follow up, or intraoperative complications. All patients underwent a complete ophthalmological examination. Optical coherence tomography examinations and microperimetry examinations were performed. RESULTS: A total of 229 patients (mean age: 57 ± 6 years) were recruited, including 179 operated patients and 50 unoperated patients. Both the best corrected visual acuity (BCVA) and macular sensitivity (MS) were significantly improved after cataract surgeries throughout the follow-up period (p = 0.000). No difference was found in the proportion of MTM staging and in the rate of resolving/stable or progressive MTM (p = 0.757) between the operated and the unoperated groups. Of all patients, those with S2 to S4 MTM at baseline had significantly higher risk of progressive MTM (p < 0.001). Patients with absence of posterior vitreous detachment or with longer axial length at baseline had higher risks of progressive MTM. CONCLUSION: Cataract surgery generally improves the BCVA and MS of highly myopic patients with MTM. Preoperative vitreoretinal adhesion, longer axial length, and S2 to S4 MTM are risk factors for progressive MTM. A long-term follow-up on the development of MTM is recommended.
PURPOSE: To evaluate the long-term effect of cataract surgery on highly myopic patients with myopic traction maculopathy (MTM) and the risk factors associated with MTM progression. METHODS: Highly myopic patients with cataract and MTM were included. Phacoemulsification surgery was performed on patients who had vision loss below 20/63 and were willing to operation. Exclusion criteria included full thickness macular hole, foveal/retinal detachment, history of vitreoretinal surgery, myopic choroidal neovascularization, macular chorioretinal atrophy, peripheral lattice degeneration, incomplete follow up, or intraoperative complications. All patients underwent a complete ophthalmological examination. Optical coherence tomography examinations and microperimetry examinations were performed. RESULTS: A total of 229 patients (mean age: 57 ± 6 years) were recruited, including 179 operated patients and 50 unoperated patients. Both the best corrected visual acuity (BCVA) and macular sensitivity (MS) were significantly improved after cataract surgeries throughout the follow-up period (p = 0.000). No difference was found in the proportion of MTM staging and in the rate of resolving/stable or progressive MTM (p = 0.757) between the operated and the unoperated groups. Of all patients, those with S2 to S4 MTM at baseline had significantly higher risk of progressive MTM (p < 0.001). Patients with absence of posterior vitreous detachment or with longer axial length at baseline had higher risks of progressive MTM. CONCLUSION:Cataract surgery generally improves the BCVA and MS of highly myopic patients with MTM. Preoperative vitreoretinal adhesion, longer axial length, and S2 to S4 MTM are risk factors for progressive MTM. A long-term follow-up on the development of MTM is recommended.