Efficacy and complications of cataract surgery in high myopia

Yao, Yunqian; Lü, Qiang; Wei, Ling; Cheng, Kaiwen; Lü, Yi; Zhu, Xiangjia

doi:10.1097/j.jcrs.0000000000000664

Cited by 31 publications

(22 citation statements)

References 63 publications

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“…Moreover, haptic design may partly affect long-term IOL stability. Our previous study showed capsular contraction syndrome occurred more frequently in the highly myopic population ( 6 ). The capsular bag starts to shrink 1 week after the operation and persists in contraction in the long run ( 21 ).…”

Section: Discussionmentioning

confidence: 96%

“…As the prevalence of high myopia rapidly increases, cataract surgery in highly myopic eyes has posed a great challenge for ophthalmologists worldwide ( 1 ), associated with more post-operative complications compared to emmetropic eyes ( 6 ). The IOL instability occurs more often in highly myopic eyes, which impairs the post-operative visual performance ( 10 , 13 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, the number of highly myopic cataract patients also increased rapidly with the high prevalence of high myopia ( 1 , 2 ). However, due to their unique anatomical structure of eyes ( 5 ), highly myopic patients are often confronted with more complications after cataract surgery compared to emmetropic patients ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes

et al. 2022

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PurposeThis study aimed to investigate the influence of intraocular lens (IOL) weight on long-term IOL stability in highly myopic eyes.Materials and MethodsA total of 205 highly myopic cataract eyes of 205 patients implanted with the MC X11 ASP (Group A, 86 eyes) or 920H IOL (Group B, 119 eyes) were included in this retrospective study. Eyes were divided into 3 subgroups according to the IOL power: low (≥-5 to <5 D), medium (≥5 to <14 D), and high (≥14 D) IOL power. At 3 years after surgery, IOL decentration and tilt, high-order aberrations, and anterior capsular opening (ACO) area were measured. The influence of IOL weight on long-term IOL stability was evaluated.ResultsGroup B had a significantly greater IOL weight than Group A (Group B vs. Group A: 28.31 ± 2.01 mg vs. 25.71 ± 4.62 mg, P < 0.001). Correspondingly, Group B presented significantly greater overall and inferior decentration than Group A, especially for low and medium IOL power (all P < 0.05). In both groups, overall and vertical decentration was significantly correlated with IOL weight (all P < 0.05). Group B showed a significantly greater ACO area than Group A (P < 0.05). Multivariate analysis showed that decentration in Group A was affected by IOL weight, while decentration in Group B was affected by IOL weight and AL.ConclusionsHigher IOL weight may lead to greater long-term IOL decentration in highly myopic eyes, while the haptic design may play a role in anterior capsular contraction.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes

et al. 2022

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“…Yao et al . [42] reported that the incidence of PCR ranges from 1.8 to 15.6% with an overall incidence of 3.91% compared with an incidence of 1.8–1.92% in the general population. A contributing factor may be a higher prevalence of thin weak zonules in high myopia, which may result in fluctuations of ACD and high mobility of the posterior capsule with subsequent rupture during cataract surgery [45].…”

Section: Refractive Outcomes and Complications Of Cataract Surgery In...mentioning

confidence: 99%

Cataract surgery in myopic eyes

Elhusseiny

Salim

2022

Current Opinion in Ophthalmology

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Purpose of reviewWe discuss the preoperative, intraoperative, and postoperative considerations for cataract surgery in eyes with high myopia. We also reviewed the recent literature on refractive outcomes and complications of cataract surgery in myopic eyes. Recent findingsSeveral novel intraocular lens (IOL) power calculation formulas have recently been developed to optimize refractive outcomes. Haigis formula is the most accurate among the third-generation IOL formulas. Novel formulas such as Barrett Universal II, Kane, and modified Wang-Koch adjustment for Holladay I formula provide a better refractive prediction compared with old formulas. Intraoperatively, the chopping technique is preferred to minimize pressure on weak zonules and reduce the incidence of posterior capsule rupture. Anterior capsular polishing is recommended to reduce the risk of postoperative capsular contraction syndrome (CCS). Postoperatively, complications such as refractive surprises, intraocular pressure spikes, and CCS remain higher in myopic eyes. Only 63% of myopic patients with axial length more than 26 mm achieve a visual acuity at least 20/40 after cataract surgery, mainly because of coexisting ocular comorbidities.

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“…In addition to routine cataract surgery, modern cataract surgery in highly myopia eyes has been shown to improve visual acuity. However, phacoemulsification-related surgery for high myopia patients is thought to be a risky procedure with common intraoperative and postoperative complications, such as posterior capsular rupture, retinal detachment, progressed myopic traction maculopathy, and capsular contraction syndrome 2 . In addition, high myopia is considered an inflammation-related disease 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

TGF-β2 levels in the aqueous humor are elevated in the second eye of high myopia within two weeks after sequential cataract surgery

Yan

Zhang

Cao

et al. 2022

Sci Rep

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Transforming growth factor-β (TGF-β) is the critical regulator of physiological and pathological conditions in lens. The TGF-β signaling pathway is closely associated with high myopia patients. Thirty eyes from fifteen patients with high myopia who received sequential cataract surgery were enrolled in this prospective study. Ten cataract patients with non-myopia were chosen as a control group. Aqueous humor (AH) samples were used to detect the levels of TGF-β1, TGF-β2, and TGF-β3 in both groups. Compared with the non-myopic cataracts patient group, the highly myopic cataracts group had a significantly higher TGF-β2 (P = 0.019). Besides, the level of TGF-β2 of the second eye was significantly higher than that in the first eye in high myopia cataract patients group (P = 0.037). And TGF-β1 showed significant differences with age and axial length of high myopia cataract patients. Therefore, TGF-β2 may contribute to the development of high myopia and cataract surgery increased the expression of TGF-β2.

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Efficacy and complications of cataract surgery in high myopia

Abstract: Modern cataract surgery is efficacious in highly myopic patients with significant improvement of visual acuity. With higher incidences of phacoemulsification-related complications, these patients warrant more attention and longer follow-up duration.

Cited by 31 publications

References 63 publications

Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes

Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes

Cataract surgery in myopic eyes

TGF-β2 levels in the aqueous humor are elevated in the second eye of high myopia within two weeks after sequential cataract surgery

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