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Refractive lens exchange for myopia: a new perspective?
1Prince Charles Eye Unit, Windsor, England. mail@eyequack.vossnet.uk
Current Opinion in Ophthalmology
|January 15, 2005
Summary
Refractive lens exchange for high myopia is reassessed. Modern techniques and patient selection show a low retinal detachment rate, suggesting it can be a safe refractive procedure.
Area of Science:
- Ophthalmology
- Refractive Surgery
Background:
- Lens surgery for high myopia has a controversial history due to concerns about retinal detachment rates.
- Colin's 1999 study highlighted a higher-than-expected incidence of retinal detachment following this procedure.
Purpose of the Study:
- To reassess the role of refractive lens exchange (RLE) in managing high myopia.
- To critically examine Colin's data in light of recent literature.
Main Methods:
- A meta-analysis of studies on RLE and cataract in high myopia published between 1996 and 2004.
- Inclusion of approximately 2036 eyes in the meta-analysis.
Main Results:
- The overall incidence of retinal detachment was 1.85% over a mean follow-up of 43.5 months.
- This rate is only slightly higher than the expected 1.5% in highly myopic populations.
- Recent studies (2003) with 4-year follow-up reported a low detachment rate (1 per 422 eyes).
- Colin's study data indicated a low posterior detachment incidence in high-risk groups with pre-existing retinal lesions.
Conclusions:
- Advancements in surgical techniques and intraocular lenses (IOLs) improve safety.
- Careful patient selection is crucial for successful outcomes.
- Refractive lens exchange can become an accepted and common refractive operation for high myopia.