The following is a summary of “Outcomes of cataract surgery in eyes with axial length > 33 mm,” published in the April 2024 issue of Ophthalmology by Zhang et al.
Complications in cataract surgery are often rare. However, the risk of developing an infection, bleeding, increased intraocular pressure, or retinal detachment remains.
Researchers conducted a prospective study evaluating the visual outcomes and perioperative complications in eyes with axial length (AL) greater than 33.0 mm undergoing cataract surgery.
They studied 122 eyes with moderately high myopia (26.0mm ≤ AL < 28.0 mm, control group) and 118 eyes with extremely high myopia (EHM) (AL > 33.0 mm, EHM group) after cataract surgery. Follow-up assessments were conducted one week and one year post-operation: myopic maculopathy grading, best-corrected visual acuity (BCVA), and complications.
The results showed that after surgery, BCVA significantly improved in the EHM group at both follow-up visits (both P<0.001), although it was still worse than the control group (both P<0.05). The EHM group had higher hyperopic refractive errors (P<0.001) associated with more severe myopic maculopathy, longer axial length, poorer second follow-up BCVA, and smaller anterior capsular opening (ACO) area. The EHM group also had a higher incidence of retinal detachment and narrower ACO (P=0.030 and <0.001, respectively), linked to longer axial length and absence of capsular tension ring (both P<0.05). There is no difference in BCVA between aphakic and pseudophakic eyes in the EHM group (both P>0.05).
Investigators concluded that cataract surgery benefits eyes with long axial lengths (>33mm) but carries equivalent risks. It is worth considering leaving these eyes aphakic for long-term safety and effectiveness.
Source: ajo.com/article/S0002-9394(24)00167-3/abstract#%20
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