Long-term results of clear lens extraction for severe myopia

Purpose: To evaluate the efficacy and safety of clear lens extraction in the management of severe myopia. Setting: Seoul National University Hospital, Seoul, Korea. Methods: This retrospective study comprised 24 eyes of 16 patients who had clear lens extraction to treat myopia of 12.00 diopters (D) or more. A scleral pocket incision and continuous curvilinear capsulorhexis were made followed by lens extraction by phacoemulsification and low-power posterior chamber intraocular lens implantation. Mean follow-up was 15 months. Results Fifteen eyes (62.0%) were within 1.00 D of targeted refractive error postoperatively; 22 (91.7%) were within +2.00 D. Uncorrected visual acuity improved in all eyes. All except 1 (95.8%) gained two or more Snellen lines. Best corrected visual acuity improved in 20 eyes (83.3%); 15 (75.0%) gained two or more lines. Best corrected visual acuity after surgery was 20/40 or better in 19 eyes (79.2%), a 37.5% increase over the preoperative number. Posterior capsule opacification developed in 1 eye; a neodymium:YAG laser posterior capsulotomy was performed at 4 months postoperatively. No retinal breaks, retinal detachments, or cystoid macular edema were observed during the follow-up. Conclusion: Clear lens extraction was effective in correcting severe myopia; however, longer follow-up of a large number of cases is needed to fully assess possible complications.