Outcomes of cataract operations in extreme high axial myopia

To analyse the outcomes of phacoemulsification in extreme axial myopia

Consecutive cases of phacoemulsification in eyes with axial length ≥ 30.0 mm from January 1, 2010 to Dec 31, 2013 in a tertiary referral eye hospital were retrospectively reviewed. A single intraocular lens (IOL) type was used for all cases. Main outcome measures included perioperative complications and refractive outcome.

Two hundred and twenty-one eyes were identified. Intraoperatively, two eyes (0.9 %) had unstable capsular bag and three (1.4 %) had posterior capsular rupture. At a mean follow-up duration was 27.4 ± 14.6 months, three eyes (1.5 % of 198 eyes with no history of retinal detachment or macular hole) developed retinal detachment. There was an overall hyperopic shift with a mean biometry error of 0.45 ± 1.21 D in all eyes. The mean absolute biometry prediction error was 0.98 ± 0.83 D in all eyes, 1.11 ± 0.86 D and 0.85 ± 0.82 D in eyes receiving negative- and positive-power IOL, respectively (p = 0.042). A total of 61.2 % of eyes had refractive outcome within ± 1.0 D of target spherical equivalent. Regression analysis showed low IOL power as an independent predictor for greater postoperative absolute biometry error (p = 0.014).

We showed no increase in perioperative complications in eyes with extreme high axial myopia. In eyes with long axial length, implantation of IOL with lower power was associated with more hyperopic shift, which was more pronounced with negative-power IOL.