Outcome of cataract surgery associated with posterior staphyloma

To assess the outcome of cataract surgery in eyes with posterior staphyloma and identify predictors of surgical success.

Tertiary care referral center.

A retrospective analysis was conducted of 107 consecutive patients with posterior staphyloma and 107 control patients who had cataract surgery. Potential associations of preoperative variables with surgical success were analyzed using the chi-square test, multivariate linear regression, and Student t test.

The staphyloma group was younger, had more women, and had a lower mean visual acuity preoperatively than the control group. All patients in the control group and all but 1 in the staphyloma group had intraocular lens (IOL) implantation at the time of cataract extraction. The rates of posterior capsule tear and vitreous loss were similar in the staphyloma and control groups. There was 1 case each of retinal detachment and IOL dislocation in the staphyloma group. The staphyloma group had significantly lower postoperative visual acuity than the control group; however, the percentage in the staphyloma group with a visual acuity of finger counting or worse decreased from 80.4% preoperatively to 16.8% postoperatively and the percentage with an uncorrected visual acuity of 20/160 or better increased from 5.6% to 67.3%. Myopic degeneration was judged to be the cause of postoperative acuity worse than 20/100 in 22.4% in the staphyloma and 0% in the control group; other causes for poor postoperative acuity were similar in the 2 groups. In the staphyloma but not the control group, decreased postoperative acuity was independently associated with age greater than 65 years and axial length greater than 29.0 mm.

Myopic degeneration may limit the results of cataract extraction in up to one fourth of patients with posterior staphyloma. Nevertheless, a substantial improvement in mean visual acuity resulted that was not associated with a significant increase in surgical complications.