Refractive lens exchange in high myopia: long term follow up

Abstract

Aim: To establish long term outcomes and incidence of complications following refractive lens exchange (RLE) for the correction of high myopia.

Methods: Operative and postoperative records of 62 cases of small incision phacoemulsification RLE performed in 37 patients over an 11 year period, by a single surgeon, were reviewed. In addition, patients were recalled for a follow up examination, which included dilated retinal examination with scleral indentation.

Results: Two cases (3.2%) of retinal detachment occurred at intervals of 2 months and 5 months following uncomplicated RLE procedures. A posterior chamber intraocular lens was inserted in 46 eyes (74%). YAG laser posterior capsulotomy was performed in 38 of 62 eyes (61%) and did not represent a risk for retinal detachment.

Conclusion: Refractive lens exchange results in rapid and predictable improvement in unaided vision in patients with high myopia. However, the risks of sight threatening complications inherent in any intraocular procedure underlie the need for appropriate patient selection.

Figure 1

Comparison of unaided visual acuity (UVA) in the early postoperative period and at long term follow up. In order to ensure graphical representation of all data points of categorical visual acuity data, each level of Snellen visual acuity was ascribed an integer score and random numbers <0.5 (generated by Excel) were added to these integers.