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 highly myopic patients who have visually significant cataracts. Setting: University-associated ophthalmology practice. Methods: This retrospective 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-shaped, self-sealing, scleral tunnel. The incision size ranged from 3.0 to 5.0 mm. Capsulorhexis was performed and then four-quadrant cracking phacoemulsification. The posterior capsule was routinely polished. A posterior chamber intraocular lens (IOL) was implanted in the capsular bag in all cases. Results: No RDs occurred during the mean follow-up of 43 months (range 9 to 77 months) or the mean follow-up after neodymium:YAG capsulotomy of 20 months. No intraoperative complications occurred. Seventy-one of 80 eyes (89%) achieved best spectacle-corrected visual acuity of 20/25 or better. Conclusions: Retinal detachments following modern cataract surgery in high myopia are much less common than previously reported. We attribute this to small incision sits, continued maintenance of the anterior chamber, posterior chamber IOL implantation, and lack of intraoperative complications.