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M. Ewald, A. J. Kanellopoulos; Post-Operative Visual Rehabilitation and Retinal Complication Results Following Phacoemulsification in High Myopia Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5460.
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To evaluate the safety, visual rehabilitation and retinal complication rate of phacoemulsification and intra-ocular lens (IOL) implantation in patients with high myopia.
Retrospective, comparative, non-interventional case series. When compared to patients with normal axial lengths, patients with high myopia (refractive error greater than -6 diopters) have a greater likelihood of developing retinal holes, tears and detachments. Cataract extraction is the most common intra-ocular procedure performed in the United States today. Thus, it is important to understand if pre-operative patient demographics change post-operative results. Since high myopia patients have an increased risk of retinal complications at baseline, it is necessary to investigate whether cataract extraction is safe and beneficial in this particular population of patients.
45 patients consisting of 27 women and 18 men, with a mean age of 54.5 and mean axial length of 26.8 (25.8-32.5).
85 eyes with pre-op mean refraction of -7.20 (-6.00 to -28.00) were evaluated for age, sex, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), intra-ocular pressure (IOP), refraction (spherical and cylindrical correction) and possible peri-operative complications of clear cornea phacoemulsification and IOL implantation. Follow-up time ranged from 11-52 months.
Mean UCVA improved from 20/800 to 20/50 and mean BSCVA improved from 20/100 to 20/35. The mean refractive error improved to -0.75 (+1.25 to -2.75), post-op IOP ranged from 17.5 to 14.5 and endothelial cell count (ECC) ranged from 2259 to 1950 mm2. There were three retinal detachments diagnosed at an average of 23 months post-operatively: two partially treated with diode laser photocoagulation and one treated with a scleral buckle.
Cataract extraction in high myopia patients appears to be very effective in visual rehabilitation, especially in regard to possible post-operative retinal complications.
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