Sight-Threatening Pathology Related to High Myopia after Posterior Chamber Lens Implantation: A Prospective Study

Abstract

OBJECTIVE:To determine the risk factors for sight-threatening complications related to myopia after extracapsular cataract extraction (ECCE) with posterior chamber lens (PCL) implantation. STUDY DESIGN: Prospective study with a maximum follow-up of 3 years. SETTING: Peripheral unit, Scarborough Hospital, UK. PATIENTS: 367 myopes out of 2408 consecutive operations of primary ECCE with PCL were grouped by axial length: group I 25.0 to 26.5 mm (moderate myopes), group II greater than 26.5 mm (high myopes). RESULTS: The overall incidence of retinal detachment (RD) was 1.9%, males being affected significantly more than females (P = 0.01) and age less than 70 years being a higher risk than over 70 years (P = 0.005). The incidence of posterior segment haemorrhage within the first year after surgery was 2.5%. However, the high myopes of group II were found to have c.2.5 times the risk of RD, 2.5 times the risk of posterior segment haemorrhage and 5 times the risk of visual loss from choroidoretinal degeneration compared with the moderate myopes of group I. CONCLUSION: To understand the risk factors for visual loss after ECCE with PCL in myopia, account should be taken of age, sex, severity of the myopia and need for posterior capsulotomy.