Purpose: To evaluate the visual outcomes and perioperative complications for cataract surgery in eyes with axial length (AL) >33.0 mm.
Design: Prospective clinical cohort study.
Methods: One hundred twenty-two eyes with moderate high myopia (26.0 mm ≤ AL < 28.0 mm, control group), and 118 eyes with extreme high myopia (AL > 33.0 mm, EHM group) were followed up after cataract surgery (1 week and 1 year post-op). Myopic maculopathy grading according to ATN system, best-corrected visual acuity (BCVA), and complications were compared.
Results: Postoperatively, BCVA in the EHM group improved significantly at both visits (both P < .001), despite being worse than that of the control group (both P < .05). The EHM group exhibited greater hyperopic refractive errors (P < .001), which were found to be associated with more severe T grade, longer AL, poorer second follow-up BCVA, and smaller anterior capsular opening (ACO) area. A higher incidence of retinal detachment and a more constricted ACO were observed in the EHM group (P = .030 and <.001, respectively), with the latter being significantly associated with longer AL and the absence of capsular tension ring (both P < .05). No difference in BCVA was found between the aphakic and pseudophakic eyes in the EHM group at both visits (both P > .05).
Conclusion: Cataract surgery improves vision of eyes with AL >33 mm, yet the increased risk of perioperative complications requires attention. Leaving these eyes aphakic might be effective and safe in the long term.
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| http://dx.doi.org/10.1016/j.ajo.2024.04.020 | DOI Listing |
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