Retinal complications after cataract extraction in patients with high myopia.

OBJECTIVE: To assess risk factors and incidence of retinal complications after cataract extraction in patients with high myopia.

DESIGN: Retrospective, noncomparative case series.

PARTICIPANTS: One hundred eighteen patients with highly myopic eyes who had an axial length of 26 mm or more (mean axial length, 30.13 +/- 2.08 mm) and who underwent cataract surgery over a period of 6 years were studied.

INTERVENTION: Patients underwent cataract extraction either by extracapsular cataract extraction (ECCE) or phacoemulsification. Prophylactic argon laser photocoagulation was performed in 13 eyes for retinal tears recognized before surgery and in 13 eyes after surgery; neodymium:YAG (Nd:YAG) laser capsulotomy was performed for patients with posterior capsule opacification (PCO) that affected the vision.

MAIN OUTCOME MEASURES: Incidence of retinal detachment and PCO and percentage of prophylactic argon laser or of Nd:YAG laser treatments.

RESULTS: Of the 118 eyes, 73 (61.9%) underwent ECCE and 45 (38.1%) underwent phacoemulsification. Posterior capsule opacification was the most common complication and was found in 30 eyes (25.4%). Thirteen patients (11%) received prophylactic laser treatment for retinal tears before cataract operation, and 13 more patients (11%) had postoperative retinal tears requiring laser treatments. None of these patients developed retinal detachment. Two patients (1.69%) developed retinal detachment within 6 months after their operations. There were no intraoperative complications, and postoperative Nd:YAG capsulotomy was not performed in these two patients.

CONCLUSIONS: Active searching and prophylactic laser treatments for retinal tears developed before and after cataract extraction in patients with high myopia are recommended. This may lower the incidence of postoperative retinal detachment.