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Purpose: To investigate the type and rate of ophthalmic complications that may occur following refractive lensectomies.
Methods: This is a retrospective consecutive case series exploring the incidence of complications in 437 eyes that received refractive lensectomies by a single surgeon from 1993 to 2000. All participants had a clear crystalline lens and a best-corrected visual acuity (BCVA) of 20/40 or better prior to the lens exchange. Main outcome measures included uncorrected visual acuity (UCVA) and BCVA after clear lensectomy, the rate of posterior capsular fibrosis formation, and retinal complications such as retinal detachments (RD) and cystoid macular edema (CME).
Results: Following the refractive lensectomy, all subjects experienced an improvement in UCVA and BCVA as compared to pre-operative levels (p<0.05). During the greater than 15-year follow-up period, 36% of subjects experienced posterior capsule opacification (PCO) requiring a Neodymium-doped ytrium aluminum garnet laser (Nd:YAG) capsulotomy, 0.23% experienced retinal detachments, and 0.46% experienced cystoid macular edema. The overall rate of retinal complications following refractive lensectomy was 0.69%. All patients with complications were treated appropriately with good outcomes.
Conclusion: This series demonstrated excellent visual acuity outcomes following refractive lensectomy. Although studies suggest that refractive lensectomy leads to high rates of retinal complications and detachments, with modern surgery it can be a safe option for patients seeking refractive surgery. Careful and continuous follow-up is essential.
Brief Summary Statement: In this retrospective case series, the incidence of ocular complications was assessed in 437 eyes that have undergone refractive lensectomies with up to 15 years of follow up. Our results show that refractive lensectomies have a superior efficacy and safety profile, with a 0.69% overall rate of retinal complications, including retinal detachments and cystoid macular edema.
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Neuhann IM, Neuhann TF, Heimann H, Schmickler S, Gerl RH, Foerster MH. Retinal detachment after phacoemulsification in high myopia: analysis of 2356 cases. J Cataract Refract Surg. 2008 Oct;34(10):1644-57.
Barraquer C, Cavelier C, Mejía LF. Incidence of retinal detachment following clear-lens extraction in myopic patients. Retrospective analysis. Arch Ophthalmol. 1994 Mar;112(3):336-9.
Alio JL, Ruiz-Moreno JM, Shabayek MH, Lugo FL, Abd El Rahman AM. The risk of retinal detachment in high myopia after small incision coaxial phacoemulsification. Am J Ophthalmol. 2007 Jul;144(1):93-98.
Ando H, Ando N, Oshika T. Cumulative probability of neodymium: YAG laser posterior capsulotomy after phacoemulsification. J Cataract Refract Surg. 2003 Nov;29(11):2148-54.
Dholakia SA, Vasavada AR, Singh R. Prospective evaluation of phacoemulsification in adults younger than 50 years. J Cataract Refract Surg. 2005 Jul;31(7):1327-33.
Zur D, Fischer N, Tufail A, Monés J, Loewenstein A. Postsurgical cystoid macular edema. Eur J Ophthalmol. 2010 Nov 11;21(S6):62-68.
Pucci V, Morselli S, Romanelli F, Pignatto S, Scandellari F, Bellucci R. Clear lens phacoemulsification for correction of high myopia. J Cataract Refract Surg. 2001 Jun;27(6):896-900.
Fernández-Vega L, Alfonso JF, Villacampa T. Clear lens extraction for the correction of high myopia. Ophthalmology. 2003 Dec;110(12):2349-54.