[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.145.218.90. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
March 1994

Clear-Lens Extraction for High MyopiaIs This an Idea Whose Time Has Come?

Author Affiliations

Washington, DC

Arch Ophthalmol. 1994;112(3):321-323. doi:10.1001/archopht.1994.01090150051020

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

Abstract

THE EXCELLENT article by Barraquer and coworkers on retinal detachment following clear-lens extraction in patients with myopia raises the important issue of appropriate thresholds of safety and efficacy for elective intraocular surgery and also helps to define the risk factors for and time course of retinal detachment following extracapsular lens (or cataract) extraction.

The literature on retinal detachment following extracapsular surgery, either for a clear or cataractous lens, has focused on three possible risk factors: younger patient age, longer axial length, and the possible role of subsequent posterior capsulotomy. In general, the probability of retinal detachment following modern extracapsular cataract extraction has been reported as 1% or less. In this series1 of 165 eyes of 107 patients with pathologic myopia, 12 eyes (7.27%) developed retinal detachment, with 75% of detachments occurring 18 months or more after surgery. Patients under the age of 30 years had 2.5 times greater odds

References
1.
Barraquer C, Cavelier C, Mejía LF.  Incidence of retinal detachment following clear-lens extraction in myopic patients: retrospective analysis . Arch Ophthalmol . 1994;112:336-339.Article
2.
Osterlin S.  On the molecular biology of the vitreous in the aphakic eye . Acta Ophthalmol (Copenh) . 1977;55:353-361.Article
3.
Burton TC.  The influence of refractive error and lattice degeneration on the incidence of retinal detachment . Trans Am Ophthalmol Soc . 1990;87:143-155.
4.
Coonan P, Fung WE, Webster RG Jr, Allen AW, Abbott RL.  The incidence of retinal detachment following extracapsular cataract extraction: a ten year study . Ophthalmology . 1985;92:1096-1101.Article
5.
Lindstrom RL, Lindquist TD, Huldin J, Rubenstein JB.  Retinal detachment in axial myopia following extracapsular cataract surgery . Trans N Orleans Acad Ophthalmol . 1988;36:253-268.
6.
Alio JL, Ruiz-Moreno JM, Artola A.  Retinal detachment as a potential hazard in surgical correction of severe myopia with phakic anterior chamber lenses . Am J Ophthalmol . 1993:115:145-148.
7.
Davidson JA.  Retinal tears and detachments after extracapsular cataract surgery . J Cataract Refract Surg . 1988;14:624-632.Article
8.
Javitt JC. Street DA, Steinberg EP. National outcomes of cataract extraction: retinal detachment and endophthalmitis following outpatient cataract extraction. Ophthalmology. In press.
9.
Steinert RF, Puliafito CA, Kumar SR, Dudak SD, Patel S.  Cystoid macular edema, retinal detachment, and glaucoma after Nd:YAG laser posterior capsulotomy . Am J Ophthalmol . 1991;112:373-380.
10.
Javitt JC, Tielsch JM, Canner JK, Kolb MM, Sommer A, Steinberg EP.  National outcomes of cataract extraction: increased risk of retinal complications associated with Nd:YAG laser capsulotomy . Ophthalmology . 1992;99:1487-1498.Article
11.
Javitt JC.  When does the failure to find a difference mean that there is none? Arch Ophthalmol . 1989;107:1034-1040.Article
12.
Folk JC. Burton TC.  Bilateral aphakic retinal detachment . Retina . 1983;3:1-6.Article
13.
Jaffe NS, Clayman HM, Jaffe MS.  Retinal detachment in myopic eyes after intracapsular and extracapsular cataract extraction: a ten year study . Am J Ophthalmol . 1984;97:48-52.
14.
Ho PC, Tolentino Fl.  Pseudophakic retinal detachment: surgical success rate with various types of IOLs . Ophthalmology . 1984;91:847-852.Article
15.
Sethi SK, Howard R, Milewski SA, Shelton P.  Pseudophakic retinal detachments . J Ocul Ther Surg . 1983;2:180-181.
16.
Freeman HM, Dobbie JG, Friedman MW, et al.  Pseudophakic retinal detachment . Mod Probl Ophthalmol . 1979;20:345-353.
17.
Yoshida A. Ogasawara H, Jalkh AE, Sanders RJ, McMeel JW, Schepens CL.  Retinal detachment after cataract surgery: surgical results . Ophthalmology . 1992;99:460-465.Article
18.
Hilton GF, McLean EB, Chuang EL. Retinal Detachment . 5th ed. San Francisco, Calif: American Academy of Ophthalmology; 1989:158-159.
19.
Weinstein MC, Feinberg HV. Clinical Decision Analysis . Philadelphia, Pa: WB Saunders Co; 1980.
×