Related Experiment Video
Updated: Jun 27, 2025

Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model
Published on: April 3, 2016
Outcomes of Cataract Surgery in Eyes With Axial Length > 33 mm
Yinglei Zhang1, Yu Du1, Anjian Wang2
1Eye Institute, Eye and Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; NHC Key Laboratory of Myopia (Fudan University) (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China.
Purpose:
To evaluate the visual outcomes and perioperative complications for cataract surgery in eyes with axial length (AL) >33.0 mm.
Design:
Prospective clinical cohort study.
Methods:
One hundred twenty-two eyes with moderate high myopia (26.0 mm ≤ AL < 28.0 mm, control group), and 118 eyes with extreme high myopia (AL > 33.0 mm, EHM group) were followed up after cataract surgery (1 week and 1 year post-op). Myopic maculopathy grading according to ATN system, best-corrected visual acuity (BCVA), and complications were compared.
Results:
Postoperatively, BCVA in the EHM group improved significantly at both visits (both P < .001), despite being worse than that of the control group (both P < .05). The EHM group exhibited greater hyperopic refractive errors (P < .001), which were found to be associated with more severe T grade, longer AL, poorer second follow-up BCVA, and smaller anterior capsular opening (ACO) area. A higher incidence of retinal detachment and a more constricted ACO were observed in the EHM group (P = .030 and <.001, respectively), with the latter being significantly associated with longer AL and the absence of capsular tension ring (both P < .05). No difference in BCVA was found between the aphakic and pseudophakic eyes in the EHM group at both visits (both P > .05).
Conclusion:
Cataract surgery improves vision of eyes with AL >33 mm, yet the increased risk of perioperative complications requires attention. Leaving these eyes aphakic might be effective and safe in the long term.
Related Concept Videos
Angle Closure Glaucoma: Treatment
Glaucoma: Overview
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...

