CLEAR LENSECTOMY AND IMPLANTATION OF LOW-POWER POSTERIOR CHAMBER INTRAOCULAR-LENS FOR THE CORRECTION OF HIGH MYOPIA

Background: Although a variety of surgical procedures to treat high my opia have been studied, no consensus exists on the optimum procedure. Clear lensectomy with implantation of a posterior chamber intraocular lens has been regarded as risky, due to the higher incidence of retina l detachment in highly myopic eyes. Methods: The authors performed sur gery and evaluation over 1 year in 52 eyes in which prophylactic retin al treatment, clear lensectomy, and posterior chamber intraocular lens implantation were used to treat high myopia of 12 diopters (D) or gre ater. Results: Before lens extraction, 31 eyes underwent argon laser p hotocoagulation. Over the 1-year period, three additional eyes were tr eated, and six eyes that had been treated preoperatively received addi tional treatment. No cystoid macular edema, retinal detachment, or per sistent corneal edema was observed in this series. At 1 year, 88.5% of the group achieved corrected visual acuity of 20/40 or better, compar ed with 75% preoperatively. Uncorrected visual acuity of 20/100 or bet ter was achieved by 84.6% of the group. The mean postoperative spheric al equivalent was - 0.86 +/- 0.84 D. Conclusion: The refractive object ives were achieved. Complications reported previously with clear lense ctomy were not experienced in this group. The low incidence of complic ations can be attributed to the short follow-up and probably in part t o the prophylactic retinal treatment, combined with the phacoemulsific ation procedure for lens extraction. Longer follow-up is needed to ful ly assess the complications. Properly randomized prospective clinical trials will be able to fully assess the benefits and risks of prophyla ctic retinal treatment and clear lens extraction with posterior intrao cular lens implantation. This series can help in evaluating this surgi cal procedure.