Purpose: To determine the outcome, including the intraoperative and postoperative complications, of phacoemulsification with intraocular lens (IOL) implantation in myopic eyes with axial length of 26 mm or more that had undergone previous pars plana vitrectomy (PPV).
Methods: This prospective study comprised 37 highly myopic eyes (axial length over 26 mm) with previous vitrectomy that underwent phacoemulsification and were reviewed at a mean postoperative follow-up of 3-6 weeks. The main outcome measures were preoperative and postoperative spherical equivalent, preoperative and postoperative visual acuity, difference between intended and achieved refraction, and any complications during cataract surgery.
Results: The mean age for cataract surgery was 61.5 years. Nuclear sclerosis was present in 91.89% of patients. The mean axial length was 27.53 mm (range 26.03-30.52 mm). The most common indication for vitrectomy in our study was retinal detachment surgery (35 out of 37). Postoperatively, 34 patients (91.89%) had a visual acuity improvement of 2 or more Snellen lines and the best-corrected visual acuity at final refraction was 6/9 (0.2 logMAR) or better in 30 patients (81.08%). Two patients had perioperative complications (5.4%).
Conclusions: Cataract surgery with IOL implantation can be performed safely in highly myopic eyes after PPV and the final visual acuity outcomes appear to be dependent on the preoperative status of the retina. Our study suggests that the incidence of intraoperative and postoperative complications can be reduced to a minimum with proper planning and meticulous attention to detail during cataract surgery.