RETINAL-DETACHMENT FOLLOWING PHACOEMULSIFICATION IN HIGHLY MYOPIC CATARACT PATIENTS

Purpose: To assess whether modern, small incision phacoemulsification techniques significantly reduce the retinal detachment(RD) risk in hig hly myopic patients who have visually significant cataracts. Setting: University-associated ophthalmology practice. Methods: This retrospect ive study included 80 eyes in 61 patients with preoperative myopia of 7.00 diopters (D) or more. Sixty-four eyes had an axial length of 25.0 mm or greater. Ail surgery was performed superiorly using a frown-sha ped, self-sealing, scleral tunnel. The incision size ranged from 3.0 t o 5.0 mm. Capsulorhexis was performed and then four-quadrant cracking phacoemulsification. The posterior capsule was routinely polished. A p osterior chamber intraocular lens (IOL) was implanted in the capsular bag in all cases. Results: No RDs occurred during the mean follow-up o f 43 months (range 9 to 77 months) or the mean follow-up after neodymi um:YAG capsulotomy of 20 months. No intraoperative complications occur red. Seventy-one of 80 eyes (89%) achieved best spectacle-corrected vi sual acuity of 20/25 or better. Conclusions: Retinal detachments follo wing modern cataract surgery in high myopia are much less common than previously reported. We attribute this to small incision sits, continu ed maintenance of the anterior chamber, posterior chamber IOL implanta tion, and lack of intraoperative complications.