The risk of retinal detachment in high myopia after small incision coaxial Phacoemulsification

PURPOSE: Report incidence and risk of retinal detachment (RD)after coaxial phacoemulsification in high my. opic patients. DESIGN: Retrospective consecutive interventional study. METHODS: SETTING: Vissum-Instituto Oftalmologico de Alicante, Spain. PATIENT OR STUDY POPULATION: A total of 439 eyes from 274 high myopic patients with spherical equivalent (SE) >= 6.00 diopters (D) or axial length >= 26.00 mm. Mean age 62.2, axial length 27.88 +/- 2.11 mm (26.0 mm to 37.9 mm), SE -13.3 +/- 5.6 (-6.00 D to -46.0 D). MAIN OUTCOME MEASURES: Incidence of RD, vitreous loss, and neodymium yttrium aluminum garnet (Nd:YAG) capsulotomy were evaluated after surgery at one, three, six, and 12 months then annually with mean follow-up 61.5 +/- 29.6 months. RESULTS: Incidence of RD was 2.7% (12/439 eyes). In eyes with :5 50 years of age was 3.65% (three eyes) compared with eyes with > 50 years of age was 2.52% (nine eyes). Cumulative risk of RD development by Kaplan-Meier analysis in all patients was 0.47%, 0.71%, 1.71%, 2.59%, and 3.28% at three, six, 15, 48, and 63 months until 105 months, respectively. In eyes :5 50 years of age: the risk increases to 1.23% at three months and 4.46% at 63 months until 147 months, whereas eyes with > 50 years of age was 0.58% and 2.96% at six and 52 months until 118 months after cataract surgery, respectively. No significant correlation was found between the occurrence of RD and vitreous loss (P <= .33) or Nd:YAG capsulotomy (P <= .50 Chi-square test). CONCLUSIONS: The incidence of RD in high myopic patients after coaxial phacoemulsification is 2.7%. A trend toward an increased incidence and risk in patients younger than 50 years of age was detected in this study.