Effect of capsular tension ring on the refractive outcomes of patients with extreme high axial myopia after phacoemulsification

PURPOSE

The aim of the study is to evaluate the effect of capsular tension ring (CTR) implantation following cataract surgery on the refractive outcomes of patients with extreme high axial myopia.

METHODS

Sixty eyes (with an axial length of ≥26 mm) were retrospectively reviewed and classified into two groups: CTR group (n = 30), which underwent CTR implantation following phacoemulsification, and control group (n = 30), which did not undergo CTR implantation. Intraocular lens (IOL) calculation was performed using Barrett Universal II (UII), Haigis, and SRK/T formulas. The refractive prediction error (PE) was calculated by subtracting the postoperative refraction from predicted refraction. The mean PE (MPE), mean absolute error (MAE), and percentages of eyes that had a PE of ±0.25, ±0.50, ±1.00, or ±2.00 diopters (D) were calculated and compared.

RESULTS

No significant differences were observed in PE between the two groups. The Barrett UII formula revealed a lower AE in the CTR group than in the control group (p = 0.015) and a lower AE than the other two formulas (p = 0.0000) in both groups. The Barrett UII formula achieved the highest percentage of eyes with a PE of ±0.25 D (66.67%).

CONCLUSIONS

The refractive outcomes were more accurate in eyes with CTR implantation than in those with routine phacoemulsification based on the Barrett UII formula. The Barrett UII formula was recommended as the appropriate formula when planning CTR implantation in high myopia.

Acute angle closure in the setting of high axial myopia: A case report

Acute angle closure is common in hyperopic eyes but uncommon in myopic eyes. Here, we report a case of angle closure attack in a 59-year-old female patient with high axial myopia. The patient presented without underlying medical history or drug history with marked congestion and progressively blurred vision in her right eye (RE) for 1 week. Initial intraocular pressure (IOP) was 40 mmHg in the RE and 19 mmHg in the left eye. Slit lamp examination revealed a very shallow anterior chamber in both eyes and marked corneal microcytic edema in the RE. Acute angle closure of the RE was diagnosed. Conservative IOP-lowering management followed by laser iridotomy was effective in managing acute high IOP crisis; however, early cataract extraction was necessary for long-term IOP control. Clinicians should be mindful of the possibility of acute angle closure even in highly axially myopic eyes.