Refractive Lens Exchange for Correction of High Myopia

Abstract

Purpose

To evaluate the efficiency and safety of refractive lens exchange for the correction of high myopia.

Methods

We made a prospective study of the results of refractive lens exchange in 72 eyes that had undergone this surgical procedure between January 1996 and January 2001. Lens extraction by phacoemulsification was done by one surgeon on 34 patients. Follow-up was five months to five years (mean 48 months). The postoperative refractive target was emmetropia or a low degree of myopia. We compared pre- and postoperative uncorrected visual acuity, and preoperative best-corrected visual acuity with postoperative uncorrected visual acuity. Intra- and postoperative complications were recorded.

Results

In 72.2% of the eyes best-corrected visual acuity (BCVA) was ≥ 0.5 before surgery. Four years after refractive lens exchange, uncorrected visual acuity (UCVA) was ≥ 0.5 in 58.3% of eyes, and the proportion of eyes with BCVA ≥ 0.5 increased to 83.3%. The sphere was fully corrected in 70.8% of cases, remained within 1.0 D of emmetropia in 87.5% and within 2.0 D of emmetropia in 95.8%. Posterior capsule opacification developed in 22 eyes (30.5%)and was treated with neodymium:YAG (Nd:YAG) laser capsulotomy Cystoid macular edema with retinal detachment occurred in one eye. No wound leakage or eye infections were observed during five years' follow-up.

Conclusions

Refractive lens exchange seems to be an effective alternative for the correction of high myopia, helping people over 40 years of age regain their distant vision.