Aim:To compare the outcomes of clear lens extraction and collamer lens implantation in high myopia. Patients and methods: Myopic patients younger than 40 years old with more than 12 diopters of myopia or who were not fit for laser-assisted in situ keratomileusis were included. Group 1 comprised patients undergoing clear lens extraction and Group 2 patients received the Visian implantable collamer lens. Outcome and complications were evaluated. Results: Postoperative best corrected visual acuity was -0.61 ± 0.18 in Group 1 and 0.79 ± 0.16 in Group 2. In Group 1, 71.4% achieved a postoperative uncorrected visual acuity better than the preoperative best corrected visual acuity, while only 51.8% patients achieved this in Group 2. Intraocular pressure decreased by 12.55% in Group 1, and increased by 15.11% in Group 2. Corneal endothelial cell density decreased by 4.47% in Group 1 and decreased by 5.67% in Group 2. Posterior capsule opacification occurred in Group 1. In Group 2, lens opacification occurred in 11.11%, significant pigment dispersion in 3.7%, and pupillary block glaucoma in 3.7%. Conclusion: Clear lens extraction presents less of a financial load up front, and less likelihood of the need for a secondary intervention in the future. Clear lens extraction is a more viable solution in developing countries with limited financial resources.

Purpose:To evaluate various phacoaspiration techniques in clear lens extraction for the incidence of intraoperative difficulties and complications.Patients and methods:This was a prospective study in which bilateral clear lens extraction was performed on 40 eyes of 20 patients, to correct high myopia. The patients were divided into 2 groups: group A underwent supracapsular phacoaspiration; group B were the contralateral eyes of the same patient. These patients were operated on with endocapsular phacoaspiration with the divide and conquer (D and C) technique. Preoperative ocular examination data were recorded and tested for significance. Intraoperative difficulties and complications such as nucleus cracking, capsule rupture and vitreous loss, and repeated chamber collapse were recorded. Postoperative examination data were recorded.Results:Mean age was 35.65 ± 5.85 years. Mean follow-up time was 17.1 ± 8.56 months. In group A mean myopia was −17.3 ± 5.07 diopters; in group B myopia was −17.9 ± 4.20 diopters. Mean preoperative uncorrected visual acuity (UCVA) was 0.04 ± 0.0167, while the mean postoperative UCVA was 0.435 ± 0.1442. There was a significant difference in pre- and postoperative BCVA within both groups, but not between the two groups. In both groups endothelial cell count (ECC) showed a significant difference between pre- and postoperative data; however, there was no statistically significant difference between both groups in postoperative ECC. The effective phacoaspiration time for group A was 4.6 ± 1.6 seconds, and for group B 9.90 ± 2.27 seconds (P < 0.005). No cases of capsule rupture occurred in group A, but 3 cases occurred in group B (15 %) (not significant, P = 0.231). Nucleus cracking did not occur in group A, but in group B 13 cases occurred (65%). Chamber collapse occurred in 4 cases (20%) in group A and 5 cases (25%) in group B (not significant, P = 1.000). Three cases of moderate postoperative iritis were recorded in group B in (15%), in which posterior capsular rupture also occurred. No cases of iritis were recorded in group A (not significant, P = 0.231). Two cases of cystoid macular edema were recorded in group B (10%) and none in group A (not significant, P = 0.487).Conclusions:Supracapsular phacoaspiration for clear lens extraction in correction of high myopia seems to present no risk for the posterior capsule, although there is a marginal risk to the ECC.

Objective:We undertook a prospective nonrandomized study to assess refractive outcome and patient satisfaction with hyperopic laser in situ keratomileusis (LASIK) using variable optical zone diameters in correction of hyperopia of more than 4.00 diopters.Methods:Fourteen adults (comprising 28 hyperopic eyes) underwent hyperopic LASIK correction for hyperopia of more than 4.00 diopters. The sample was divided into two groups. Group 1 included the right eyes of the 14 patients who underwent hyperopic LASIK using a 6.5 mm optical zone diameter. Group 2 comprised the left eyes of the same patients with the only difference being that the optical zone diameter was 6.0 mm.Results:The mean age of the patients was 36.42 ± 5.10 years. Group 1 eyes had a median (range) preoperative uncorrected visual acuity (UCVA) of 0.79 (0.52) and best-corrected visual acuity (BCVA) of 0.15 (0.08). Group 2 had a median preoperative UCVA of 0.79 (0.60) and BCVA of 0.15 (0.08). The median postoperative UCVA in Group 1 was 0.17 (0.21) and BCVA was 0.15 (0.13). In Group 2, the median postoperative UCVA was 0.30 (0.32) and BCVA was 0.15 (0.26). Group 1 had a median preoperative refraction of +5.37 (1.75) diopters and the median postoperative refraction at one week was −0.23 (1.25) diopters, at three months was +0.75 (0.75) diopters, and at six months was +0.75 (1.00) diopters. Group 2 had a median preoperative refraction of +5.00 (1.75) diopters, and the median postoperative refraction at one week was +0.13 (1.5) diopters, at three months was +1.00 (0.75) diopters and at six months +1.25 (1.25) diopters. The difference was statistically significant between groups 1 and 2. The difference within each group was also significant. Group 1 eyes were stabilizing after the three-month period in contrast with Group 2 in which the refractive changes continued throughout the follow-up period.Conclusion:Larger optical zone diameter in correction of hyperopia of more than 4.00 diopters was more predictable, stable and safe.

Anterior lens capsule is effective in phacotrabeculectomies.