[Risk of retinal detachment in pseudophakia and axial myopia]

The incidence of retinal detachment on axial myopic pseudophakic eyes after Nd:Yag laser capsulotomy or intraoperative complications varies in the literature. In this study we analysed the incidence of retinal detachment in 136 pseudophakic myopic eyes (axial length > or = 26.0 mm) with and without capsulotomy and after intraopertive complications. These results were compared with those published in the literature and those obtained in a control group of 136 pseudophakic eyes with an axial length of less than 26.0 mm. Both groups were followed up for 2 years following operations in 1989 and 1990. The incidence of retinal detachment in eyes with axial myopia > or = 26.0 mm was 3.6% (5/136), without capsulotomy 3.3% (3/90) and with capsulotomy 2.5% (1/40). Intraoperative defects of the posterior capsule occurred in 6 cases, and in 1 case retinal detachment (1/6) developed. No retinal detachment occurred in the control group. The risk of retinal detachment does not seem to be significantly higher after uncomplicated extracapsular cataract extraction in eyes with axial myopia than in myopic eyes in which cataract extraction has not been performed. The combination of capsulotomy and axial myopia does not seem to increase the risk of retinal detachment. However, intraoperative complications do increase the risk of retinal detachment. Retinal detachment is three times as likely to develop in pseudophakic myopic eyes as in eyes with normal axial length.