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Yao Y, Lu Q, Wei L, Cheng K, Lu Y, Zhu X. Efficacy and complications of cataract surgery in high myopia. J Cataract Refract Surg 2021; 47:1473-1480. [PMID: 33929806 DOI: 10.1097/j.jcrs.0000000000000664] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/20/2021] [Indexed: 11/26/2022]
Abstract
To evaluate the efficacy and complications of cataract surgery in high myopia, a comprehensive search query was conducted from January 2000 to August 2020. A total of 19 586 highly myopic eyes from 28 studies were included. Modern cataract surgery turns out efficacious in highly myopic eyes with significant improvement of visual acuity. However, phacoemulsification-related complications such as posterior capsular rupture (3.91%, 95% CI, 1.98%-6.37%), retinal detachment (1.74%, 95% CI, 1.36%-2.15%), progressed myopic traction maculopathy (5.07%, 95% CI, 1.80%-9.37%), capsular contraction syndrome (2.1%), intraocular lens dislocation (0.58%), and transient intraocular pressure elevation (28.15%, 95% CI, 20.29%-36.70%) occurred more frequently in the highly myopic population. Separate analyses were also conducted based on follow-up period. In conclusion, modern cataract surgery was effective for highly myopic cataract patients, whereas careful precautions and sufficient follow-ups were of great value because of higher incidences of intraoperative and postoperative complications.
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Affiliation(s)
- Yunqian Yao
- From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Tassignon MJ, Van den Heurck JJI, Boven KBM, Van Looveren J, Wouters K, Bali E, Ní Dhubhghaill S, Mathysen DGP. Incidence of rhegmatogenous retinal detachment after bag-in-the-lens intraocular lens implantation. J Cataract Refract Surg 2015; 41:2430-7. [PMID: 26703493 DOI: 10.1016/j.jcrs.2015.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/13/2015] [Accepted: 05/18/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the incidence of rhegmatogenous retinal detachment (RRD) and associated risk factors after phacoemulsification and bag-in-the-lens intraocular lens (IOL) implantation. SETTING Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium. DESIGN Prospective cohort study. METHODS All consecutive bag-in-the-lens IOL implantations performed between January 2001 and December 2007 were included, with the exception of combined procedures and IOL exchanges. The retinal detachment (RD) incidence was studied in the total cohort, in a subgroup of patients with 1 to 5 years of follow-up, and finally in the group remaining after exclusion of all risk factors except gender. RESULTS RD after bag-in-the-lens IOL implantation in 1323 eyes with an average follow-up of 44.75 months (range 0 to 152 months) was found in 19 eyes (1.44%). The 1-year RD incidence was 0.49% (5 RD cases in 1024 eyes) (0.00% in patients without risk factors). The 2-year cumulative RD incidence was 0.84% (9 RD cases in 931 eyes; 0.15% without risk factors). Four clinically significant risk factors were confirmed: male gender, young age at time of surgery (<60 years), axial myopia (axial length ≥25 mm), and history of contralateral RD in the total cohort. CONCLUSION The RRD incidence following bag-in-the-lens IOL implantation was comparable to that seen after lens-in-the-bag (LIB) implantation. The wide variation in study design in the literature precludes direct comparison, so there is a need for standardization in evaluating RRD incidence after cataract surgery. Future prospective studies should consider patients with and without risk factors (except gender) separately. FINANCIAL DISCLOSURE Prof. dr. M.J. Tassignon has intellectual property rights to the bag-in-the-lens intraocular lens (U.S. patent 6 027 531; EU patent 009406794; PCT/120268), which is licensed to Morcher GmbH, Stuttgart, Germany.
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Affiliation(s)
- Marie-José Tassignon
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Jonas J I Van den Heurck
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Kim B M Boven
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Jan Van Looveren
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Kristien Wouters
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Ernesto Bali
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Sorcha Ní Dhubhghaill
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Danny G P Mathysen
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium.
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