J Colin1, A Robinet. 1. Hospital Morvan, Centre Hospitalier Universitaire de Brest, France.
Abstract
BACKGROUND: Although a variety of surgical procedures to treat high myopia have been studied, no consensus exists on the optimum procedure. Clear lensectomy with implantation of a posterior chamber intraocular lens has been regarded as risky, due to the higher incidence of retinal detachment in highly myopic eyes. METHODS: The authors performed surgery and evaluation over 1 year in 52 eyes in which prophylactic retinal treatment, clear lensectomy, and posterior chamber intraocular lens implantation were used to treat high myopia of 12 diopters (D) or greater. RESULTS: Before lens extraction, 31 eyes underwent argon laser photocoagulation. Over the 1-year period, three additional eyes were treated, and six eyes that had been treated preoperatively received additional treatment. No cystoid macular edema, retinal detachment, or persistent corneal edema was observed in this series. At 1 year, 88.5% of the group achieved corrected visual acuity of 20/40 or better, compared with 75% preoperatively. Uncorrected visual acuity of 20/100 or better was achieved by 84.6% of the group. The mean postoperative spherical equivalent was -0.86 +/- 0.84 D. CONCLUSION: The refractive objectives were achieved. Complications reported previously with clear lensectomy were not experienced in this group. The low incidence of complications can be attributed to the short follow-up and probably in part to the prophylactic retinal treatment, combined with the phacoemulsification procedure for lens extraction. Longer follow-up is needed to fully assess the complications. Properly randomized prospective clinical trials will be able to fully assess the benefits and risks of prophylactic retinal treatment and clear lens extraction with posterior intraocular lens implantation. This series can help in evaluating this surgical procedure.
BACKGROUND: Although a variety of surgical procedures to treat high myopia have been studied, no consensus exists on the optimum procedure. Clear lensectomy with implantation of a posterior chamber intraocular lens has been regarded as risky, due to the higher incidence of retinal detachment in highly myopic eyes. METHODS: The authors performed surgery and evaluation over 1 year in 52 eyes in which prophylactic retinal treatment, clear lensectomy, and posterior chamber intraocular lens implantation were used to treat high myopia of 12 diopters (D) or greater. RESULTS: Before lens extraction, 31 eyes underwent argon laser photocoagulation. Over the 1-year period, three additional eyes were treated, and six eyes that had been treated preoperatively received additional treatment. No cystoid macular edema, retinal detachment, or persistent corneal edema was observed in this series. At 1 year, 88.5% of the group achieved corrected visual acuity of 20/40 or better, compared with 75% preoperatively. Uncorrected visual acuity of 20/100 or better was achieved by 84.6% of the group. The mean postoperative spherical equivalent was -0.86 +/- 0.84 D. CONCLUSION: The refractive objectives were achieved. Complications reported previously with clear lensectomy were not experienced in this group. The low incidence of complications can be attributed to the short follow-up and probably in part to the prophylactic retinal treatment, combined with the phacoemulsification procedure for lens extraction. Longer follow-up is needed to fully assess the complications. Properly randomized prospective clinical trials will be able to fully assess the benefits and risks of prophylactic retinal treatment and clear lens extraction with posterior intraocular lens implantation. This series can help in evaluating this surgical procedure.