Complications of clear lens extraction in axial myopia

Clear lens extraction is a refractive surgery used to compensate axial myopia. Formerly, intracapsular lens extraction was performed, but the present surgical method is extracapsular lens extraction or phacoemulsification. Clear lens extraction is becoming controversial because of the danger of complications. We retrospectively reviewed the postoperative complications in 33 eyes of 20 patients who underwent clear lens extraction at other institutions between 1966 and 1984. Twelve patients (60%) had motility disturbances. Eight (24%) of 33 eyes suffered secondary glaucoma; ten (30%), retinal detachment; 12 (36%), lens remnants in the pupillary space; and six (18%), blindness caused by clear lens extraction or by additional surgery performed by us while attempting to improve a poor prognosis. Clear lens extraction appears to be contraindicated in the young, in those with axial diameters greater than 29 mm, and in those presenting with peripheral chorioretinal degeneration. Moreover, clear lens extraction does not avoid the progression of myopia at the posterior segment. We suggest the use of safer, noninvasive, reversible alternatives.