Pseudophakic retinal detachment in high axial myopia

J Cataract Refract Surg. 1997 Sep;23(7):1095-102. doi: 10.1016/s0886-3350(97)80087-9.


Purpose: To investigate the effect of extracapsular cataract surgery with intraocular lens (IOL) implantation and neodymium:YAG (Nd:YAG) laser posterior capsulotomy on the rate of retinal detachment (RD) in myopic eyes with an axial length of 27 mm or more.

Setting: Department of Ophthalmology, University of Giessen, Germany.

Methods: This retrospective, nonrandomized study comprised the records of 386 consecutive surgical procedures in 275 patients performed between December 1985 and December 1993. In May 1994, all patients were asked by a mailed questionnaire whether they had had an RD in either eye or laser treatment for posterior capsule opacification. Responses from 190 patients concerning 253 surgical procedures were evaluated.

Results: The pseudophakic RD rate was 0.8% (two cases). One patient developed aphakic RD after IOL explanation. One expulsive choroidal hemorrhage occurred during secondary IOL implantation. Four eyes (1.6%) had vitreous loss, and 74 eyes (29.2%) had an Nd:YAG capsulotomy. Mean axial length was 29.2 mm +/- 1.71 (SD), mean follow-up was 3.8 +/- 2 years, and mean age at surgery was 69.8 +/- 12 years.

Conclusion: Pseudophakia with no other risk factor posed little additional risk for RD in eyes with high axial myopia; however, Nd:YAG laser posterior capsulotomy was a risk factor for pseudophakic RD. Complicated surgery, such as a secondary procedure or vitreous loss, and young age were major causative factors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cataract Extraction / adverse effects
  • Female
  • Humans
  • Incidence
  • Laser Therapy
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Myopia / complications*
  • Pseudophakia / etiology*
  • Retinal Detachment / etiology*
  • Retrospective Studies
  • Risk Factors
  • Surveys and Questionnaires