Cataract Surgery in Eyes with High Myopia

PurposeTo evaluate whether the presence of dome-shaped macula (DSM) is a protective factor for visual acuity after cataract surgery in patients with high myopia.MethodsIncluded were 891 highly myopic cataract eyes (600 patients) that were examined by optical coherence tomography (OCT) through the central fovea and underwent cataract surgery in our hospital. DSM was defined as an inward bulge >50 µm in horizontal or vertical OCT sections. The incidences of various maculopathies were compared between eyes with and those without DSM. The influences of age, sex, eye laterality, axial length and DSM on postoperative visual acuity were evaluated by multivariate linear regression.ResultsOf the 891 eyes, 123 (13.8%) had DSM. There was a greater association of DSM with extrafoveal retinoschisis (RS) than with other vision-threatening complications such as foveal RS and choroidal neovascularisation. In addition to axial length and age, sex was associated with the presence of DSM (p=0.016). In bilateral high myopia, the incidence of DSM increased with the degree of anisometropia and was more common in the longer eye of patients with anisometropia. Younger age, male sex, shorter axial length and the presence of DSM were associated with better postoperative visual acuity in highly myopic cataract eyes (β=0.124, p=0.002; β=0.142, p<0.001; β=0.275, p<0.001 and β=−0.088, p=0.038, respectively).ConclusionAssociated with fewer visual threatening macular complications, presence of DSM may be a protective factor for visual function after cataract surgery in highly myopic eyes.

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Efficacy and complications of cataract surgery in high myopia

Journal of Cataract & Refractive Surgery ◽

10.1097/j.jcrs.0000000000000664 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Yunqian Yao ◽

Qiang Lu ◽

Ling Wei ◽

Kaiwen Cheng ◽

Yi Lu ◽

...

Keyword(s):

Cataract Surgery ◽

High Myopia

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Intraocular Lens Power Calculation for Cataract Surgery after Photorefractive Keratectomy for High Myopia

Journal of Refractive Surgery ◽

10.3928/1081-597x-19970701-12 ◽

1997 ◽

Vol 13 (4) ◽

pp. 362-366 ◽

Cited By ~ 2

Author(s):

Richard S Kalski ◽

Jean-Pierre Danjoux ◽

Graham E Fraenkel ◽

Michael A Lawless ◽

Christopher Rogers

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

High Myopia ◽

Photorefractive Keratectomy ◽

Power Calculation ◽

Intraocular Lens Power Calculation ◽

Intraocular Lens Power ◽

Lens Power ◽

Lens Power Calculation

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Outcomes after Cataract Surgery in High Myopes with Axial Length Differences of ≥2 mm

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.8.1036 ◽

2021 ◽

Vol 62 (8) ◽

pp. 1036-1042

Author(s):

Yeon Jeong Lee ◽

Yung-Ju Yoo ◽

Sang Beom Han

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Cataract Surgery ◽

Axial Length ◽

High Myopia ◽

Demographic Data ◽

Linear Regression Analysis ◽

Visual Outcome ◽

Macular Thickness ◽

Multivariate Linear Regression Analysis

Purpose: To evaluate the visual outcome after cataract operations in high myopia patients, whose axial length differences are longer than 2 mm.Methods: A retrospective study was conducted on patients who had received phacoemulsification cataract surgery from January 2014 to June 2020. The patients whose axial lengths and inter-eye axial lengths exceeded 26 and 2 mm, respectively, were selected. Demographic data, axial lengths, central subfield macular thickness, retinal nerve fiber layer, and best-corrected visual acuities (BCVAs) before and at 6 months postoperatively were collected. The factors related to visual outcome were analyzed using univariate, multivariate linear regression.Results: Twelve patients had an inter-eye axial length difference longer than 2 mm. The average axial lengths of longer and shorter eyes were 29.17 ± 1.94 and 26.66 ± 2.51 mm, respectively (p = 0.02, Mann-Whitney U-test). The BCVAs (logarithm of minimal angle of resolution, logMAR) of the longer and shorter eyes before the surgery were 1.09 ± 0.62 and 0.19 ± 0.16, respectively (p = 0.03, Mann-Whitney U-test). The BCVAs (logMAR) of the longer and shorter eyes 6 months after surgery were 0.19 ± 0.16 and 0.08 ± 0.10, respectively (p = 0.11, Mann-Whitney U-test). In univariate linear regression analysis, the BCVAs 6 months after the surgery showed better preoperative BCVAs (p < 0.001) and a thinner central subfield macular thickness (p = 0.001). In multivariate linear regression analysis, the BCVA at 6 months after the surgery showed significant improvement compared with preoperative BCVA values (p < 0.001).Conclusions: High myopia patients whose axial length differences exceeded 2 mm showed improved VA after cataract surgery.

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Evaluation of preoperative corneal astigmatism using swept-source optical biometry in Chinese cataract surgery candidates with high myopia: a prospective, comparative observational study

Annals of Translational Medicine ◽

10.21037/atm-20-6757 ◽

2021 ◽

Vol 9 (8) ◽

pp. 618-618

Author(s):

Yehui Tan ◽

Liangping Liu ◽

Jianbing Li ◽

Yingyan Qin ◽

Ao Sun ◽

...

Keyword(s):

Observational Study ◽

Cataract Surgery ◽

High Myopia ◽

Corneal Astigmatism ◽

Swept Source ◽

Optical Biometry

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Posterior Wall Collapse in High Myopia following Cataract Surgery

Case Reports in Ophthalmology ◽

10.1159/000487077 ◽

2018 ◽

Vol 9 (1) ◽

pp. 167-171

Author(s):

Galia A. Deitz ◽

Adam R. Sweeney ◽

Hoon C. Jung

Keyword(s):

Cataract Surgery ◽

High Myopia ◽

Posterior Wall ◽

Pathologic Myopia ◽

Uncorrected Distance Visual Acuity ◽

Patient Reported ◽

History Of ◽

Pars Plana ◽

Initial Recovery

Purpose: We report a case of posterior globe collapse of an eye after initial recovery from uncomplicated cataract surgery in a patient with high myopia and discuss the course of management involving recognition and emergent air injection with globe reformation. Case Report: A 64-year-old functionally monocular male with a history of high myopia presented for follow-up after uncomplicated cataract surgery. Uncorrected distance visual acuity (UCDVA) at postoperative day 1 was 20/150 with an intraocular pressure (IOP) of 19 mm Hg. At the week 1 visit, UCDVA had decreased to 20/200 with an IOP at 9 mm Hg. After preliminary exam, the keratome site suture was removed, after which the patient reported vision changes. A dilated fundus exam was performed revealing posterior scleral wall collapse. A clinical diagnosis of hypotony was made and a pars plana injection of 1 mL air was performed. This resulted in immediate subjective improvement of vision. Exam the next day revealed UCDVA 20/50 with pinhole improvement to 20/30 and IOP 15 mm Hg. Conclusion: This case demonstrates postoperative hypotony in a patient with pathologic myopia, following cataract surgery. Pathologically myopic eyes may have greater propensity to collapse in the setting of reduced IOP.

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