Spontaneous Resolution of Vitreoretinal-Iinterface Disorders

PURPOSE: To review the mechanisms and clinical patterns of spontaneous resolution of vitreoretinal interface disorders by analyzing cases and available literature on macular hole (MH), vitreoretinal traction (VMT), and epiretinal membrane (ERM). METHODS: Medical records and optical coherence tomography (OCT) images of patients with spontaneous resolution of MH, VMT, and ERM were reviewed. RESULTS: Two eyes with VMT, 3 eyes with idiopathic MH, 3 eyes of traumatic MH (including 1 eye with electrical burn), and 2 eyes with ERM showed spontaneous resolution. All eyes except traumatic MH reached a visual acuity better than 0.5 after resolution. All idiopathic MHs achieved anatomic closure in 6 months, and traumatic MHs in 1 month except for the electrical burn case. Seven out of 10 eyes experienced complete posterior vitreous detachment (PVD) during resolution. CONCLUSIONS: Some cases of vitreoretinal interface disorders can resolve spontaneously with complete PVD or other mechanisms. Indicators predicting spontaneous resolution should be considered in patients with vitreoretinal interface disorder.

Effect of Haptic Material and Number of Intraocular Lens on Anterior Capsule Contraction after Cataract Surgery

PURPOSE: To evaluate changes over time of the anterior capsule opening size after phacoemulsification, based on haptic number and composition of three acrylic intraocular lenses (IOLs). METHODS: Fifty-five patients (70 eyes) were included. All underwent phacoemulsification followed by implantation of either an acrylic IOL with two-haptic (one-piece, 26 eyes; three-piece, 22 eyes), or four-haptic (one-piece, 22 eyes). The area of the anterior capsule opening size was measured one week postoperatively (baseline) and at three months. RESULTS: There was a significant reduction in the area of the anterior capsule opening from one week as compared to three months postoperatively in all groups (p < 0.001). However, there was no significant difference in the reduction in the anterior capsule opening between the IOLs (p = 0.36). CONCLUSIONS: The number and material of the haptic of the three acrylic IOLs did not influence the degree of anterior capsule opening shrinkage.

Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients Younger than 50 Years of Age

PURPOSE: To evaluate the cumulative incidence and estimate the risk factors of Nd:YAG capsulotomy due to posterior capsular opacification in adult cataract patients younger than 50 years of age. METHODS: In the present study we retrospectively reviewed 118 consecutive eyes that received phacoemulsification and intraocular lens implantation. We analyzed the cumulative incidence of Nd:YAG posterior capsulotomy and the associated risk factors. RESULTS: The cumulative incidence of posterior capsulotomy was 4.24%, 5.08%, 8.47%, 15.25%, and 20.34% in adults younger than 50 years of age at 3 months, 6 months, 12 months, 24 months, and more than 24 months after cataract surgery, respectively. The nuclear type (p = 0.021) and the mature type (p = 0.014) cataract groups were strongly associated with an increased risk of posterior capsulotomy compared with the posterior subcapsular type. The hydrophobic and single-piece intraocular lens caused the lowest incidence of posterior capsulotomy among intraocular lenses used for cataract surgery (p = 0.028). The subgroup analysis showed no statistical significance between gender, existence of diabetic mellitus or glaucoma, intraocular lens haptic material and the risk of posterior capsulotomy (p > 0.05). CONCLUSIONS: The cumulative incidence of Nd:YAG capsulotomy was 20.34% in adults younger than 50 years of age and at more than 24 months after cataract surgery. The risk factors associated with posterior capsulotomy included nuclear and mature cataract types. Additionally, there was a difference in the incidence of posterior capsulotomy according to the type of intraocular lenses.

The Correlation of Differences in the Ocular Component Values with the Degree of Myopic Anisometropia

PURPOSE: To determine the relationship between the differences in the ocular component values with the degree of anisomyopia. METHODS: Refraction, corneal power (CP), and biometry were examined in 50 myopic adults with refractive differences (RD) over 1.50 diopters (D). Ocular components were measured by ultrasound biometry and keratometry. The correlation between the differences in the ocular component values with the degree of anisomyopia was analyzed by linear regression analysis. RESULTS: Among 50 adults with anisomyopia, 5 had RD from 1.50 to 2.99 D, 11 had RD from 3.00 to 3.99 D, 9 had RD from 4.00 to 5.99 D, 12 had RD from 6.00 to 7.99 D, 7 had RD from 8.00 to 11.99 D, and 6 had > or =12.00 D. There was no significant correlation between the ocular components (CP, crystalline lens thickness [LT], and anterior chamber depth [ACD], and the length from the cornea to the posterior surface of the lens [ACD + LT]) and the RD (p > 0.05). The RD showed a significantly positive correlation with vitreous chamber depth (VCD), and axial length (r = 0.963, p < 0.0001). CONCLUSIONS: The severity of anisomyopia was not correlated with the between-eye differences in the anterior chamber values of the eye (CP, ACD, LT, ACD + LT). The severity of anisomyopia was significantly correlated with the between-eye differences in VCD.

Expression of Nerve Growth Factor during Corneal Epithelial Wound Healing in Rats

PURPOSE: To evaluate the expression of nerve growth factor (NGF) in the rat cornea and lacrimal gland before and after corneal epithelial wounding. METHODS: Twenty-nine Sprague-Dawley male rats were used in the present study. Corneal trephination was performed using a 4.0-mm diameter trephine before scratch and at 24, 48, 72 hours after debridement. The lacrimal gland was excised before scratch and at 24 hours after epithelial debridement. NGF levels of the excised cornea and lacrimal gland were measured in rat corneas by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry staining was performed on rat corneas and lacrimal glands. RESULTS: The NGF/total protein ratio (NGF/tP) increased after wounding in the cornea and lacrimal gland. NGF levels in the cornea significantly increased in the wounded group until the 2nd day after wounding (p < 0.05). After NGF concentration peaked on the 1st day, there was a progressive decline after wounding. Additionally, the NGF concentration in the lacrimal gland of the wounded group was significantly higher than that of the control group at 24 hours after epithelial debridement (p = 0.001). Immunohistochemistry staining showed that NGF staining was stronger in rat corneas and lacrimal glands after epithelial debridement than before. CONCLUSIONS: Expression of NGF increased in rat corneas and lacrimal glands after corneal epithelial wounding, which suggests that NGF may play an important role in corneal wound healing.

Toxic Anterior Segment Syndrome Following Cataract Surgery

PURPOSE: To report clinical and laboratory findings of toxic anterior segment syndrome (TASS) in seven patients following cataract surgery with intraocular lens (IOL) implantation. METHODS: The medical records of seven patients who underwent cataract surgery associated with postoperative decreased visual acuity, ocular pain, anterior chamber inflammation and corneal edema between Feb 2007 and Nov 2009 were retrospectively reviewed. RESULTS: All patients were over 60 years of age, four patients had diabetes and four patients had cardiovascular disease. Five patients had received hydrophilic IOL, and six patients underwent surgery later in order. All seven patients presented with increased anterior segment inflammation, acute decreased visual acuity, and severe corneal edema an average of 10.4 days (range 1 to 15 days) after surgery. Treatment of the seven patients included intensive topical and oral steroids, and improvement was noted in all patients. CONCLUSIONS: The incidence of TASS after cataract surgery was 0.8%, and was significantly higher in cases of hydrophilic IOL insertion (5 of 284 cases, 1.76%) compared to cases of hydrophobic IOL insertion (2 of 581 cases, 0.34%) (p = 0.04). Five of the seven cases presented with TASS at postoperative day 14. Inflammation improved in all patients with steroid treatment.

Comparison of the Effects of Patterned and Conventional Panretinal Photocoagulation on Diabetic Retinopathy

PURPOSE: To compare the therapeutic effects and complications after panretinal photocoagulation (PRP) and discomforts of patients using patterned PRP versus conventional PRP for diabetic retinopathy. METHODS: Eighty patients who required PRP due to diabetic retinopathy were enrolled in a prospective randomized controlled study. The patients were randomly divided into two groups: a patterned PRP group in which PRP was performed with a short laser exposure time (0.02 seconds) and a conventional PRP group with a long exposure time (0.2 seconds). At the 1-year follow-up visit, the progressions of diabetic retinopathy, best-corrected visual acuity, and central macular thickness were evaluated. All patients were questioned about the grade of pain during PRP. In addition, the complications after PRP were investigated. RESULTS: There were no statistical differences in clinical characteristics between both groups. The progression of diabetic retinopathy was not different in both groups at the 1-year follow-up visit. The best-corrected visual acuities at 1, 2, 4, and 8 weeks after PRP were decreased in both groups and, in the conventional PRP group, the decrements of visual acuity were greater than in the patterned PRP group. The increments of central macular thickness were also greater in the conventional PRP group than the patterned PRP group. CONCLUSIONS: When patterned PRP is performed using a short laser exposure time, the efficacy in the treatment of diabetic retinopathy is similar to that of the conventional PRP using a longer laser exposure time. Moreover, patterned PRP is less painful, and fewer complications.

Comparison of the Effects of Patterned and Conventional Laser Photocoagulation in Branch Retinal Vein Occlusion

PURPOSE: To compare the clinical effect and complications between patterned laser photocoagulation with short exposure time and conventional laser photocoagulation for neovascularization in branch retinal vein occlusion (BRVO). METHODS: A prospective study was conducted on 36 patients (39 eyes) who required laser photocoagulation for neovascularization due to BRVO. The patients were divided into 2 groups, the patterned laser photocoagulation group (laser exposure time 0.02 sec, 3 x 3 array patterned photocoagulation) and conventional laser photocoagulation group (laser exposure time 0.2 sec). Other laser parameters (burn intensity and spot size) were the same. Pain score at the time of treatment was monitored after the laser photocoagulation. In addition, best-corrected visual acuity as well as central macular thickness measurements were performed before the treatment and after 2, 4, 8, and 12 weeks. The regression of neovascularization in fluorescein angiography was monitored during follow-up periods. RESULTS: The patterned laser photocoagulation group had a greater reduction in pain during laser photocoagulation, and a decreased change in central macular thickness after laser photocoagulation than the conventional laser photocoagulation group. In particular, the patterned laser photocoagulation group had a statistically significant difference between the 2 groups at postoperative 8 and 12 weeks. The regression rate of neovascularization between the 2 groups had no statistically significant difference. CONCLUSIONS: Patterned laser photocoagulation with a short exposure time decreases pain and postoperative macular edema with no difference in regression of neovascularization. Patterned laser photocoagulation with a short exposure time can be considered as a useful and efficient method for neovascularization in BRVO.

Stability of Four-Haptic Intraocular Lens in Combined Phacoemulsification and Vitrectomy

PURPOSE: To evaluate the stability of intraocular lenses (IOLs) according to the haptic design in combined surgery (phacoemulsification, intraocular lens insertion, and vitrectomy) by comparing early IOP elevation and the accuracy of IOL power. METHODS: A retrospective study was conducted for 85 eyes of 85 patients who had undergone combined surgery. IOP elevation one week postoperatively and the difference between target refraction and postoperative refraction after two months were evaluated in all patients. All eyes were allocated to either a 2-haptic IOL group or a 4-haptic IOL group, and then each group was divided into three subgroups: gas-filled, silicone oil-filled, or balanced salt solution-filled. RESULTS: In the balanced salt solution-filled group, the early IOP increase was significantly less in the 4-haptic IOL group than it was in the 2-haptic IOL group (3.24 mmHg vs. 6.15 mm Hg, p=0.025). The myopic shifts of the 2-haptic IOL group were significantly greater than those of the 4-haptic IOL group for all of the subgroups (gas subgroup -0.71D vs. -0.31D, p=0.045; balanced salt solution subgroup -0.66D vs. -0.16D, p=0.018). CONCLUSIONS: In combined surgery, 4-haptic IOL implantation showed significantly less early IOP elevation and less myopic shift than those of 2-haptic IOL implantation.

Clinical Results of Cataract Surgery in Nanophthalmic Eyes

PURPOSE: To evaluate the outcomes in patients with nanophthalmos that had phacoemulsification and intraocular lens (IOL) implantation. METHODS: This retrospective study included 13 eyes of eight patients with nanophthalmos who had phacoemulsification with IOL implantation: Preoperative and postoperative manifest refraction, best-spectacle corrected visual acuity (BSCVA), preoperative axial length, anterior chamber depth, corneal diameter, manual keratometry, intraocular pressure (IOP), and postoperative complications were analyzed. RESULTS: Eight patients (13 eyes) had phacoemulsification with IOL implantation, 11 eyes by posterior chamber IOL implantation, and two eyes by ciliary sulcus fixation. The mean change in visual acuity from preoperative to postoperative was 2.1+/-2.0 lines. IOP was well controlled postoperatively, but one eye required a trabeculectomy. No patients required partial sclerotomy during the operation. Choroidal effusions or choroidal detachment was not observed intraoperatively or postoperatively. The mean endothelial cell loss was 12.6+/-17.7% at two months postoperative. CONCLUSIONS: The results of phacoemulsification and IOL implantation through clear corneal incision in nanophthalmic patients are encouraging. Most patients showed improved visual acuity without severe complications.

The Short-Term Efficacy of Intravitreal Ranibizumab in the Treatment of Diabetic Macular Edema

PURPOSE: To evaluate the short-term effect of an intravitreal injection of ranibizumab in the treatment of diabetic macular edema. METHODS: Eighteen eyes of 18 patients who underwent intravitreal ranibizumab injection for the treatment of diabetic macular edema between March 1 and November 30, 2009 were retrospectively evaluated. Complete ophthalmic examinations including best corrected visual acuity and optical coherence tomography (OCT) were performed at baseline and follow-up visits at one and three months. RESULTS: The mean Visual Acuity Improved From Logmar 0.74 +/- 0.45 At Baseline To Logmar 0.44 +/- 0.26 At One Month And To Logmar 0.42 +/- 0.23 At Three Months (P < 0.05). The Mean Central Macular Thickness Decreased From 429.5 +/- 71.9 microM At Baseline To 299.9 +/- 81.2 microM At One Month And To 284.6 +/- 82.6 microM At Three Months (P < 0.05). No Adverse Side Effects Were Observed Following the injections. CONCLUSIONS: The observed macular edema and visual acuity improvements demonstrated that intravitreal ranibizumab injection may be useful for the treatment of patients with diabetic macular edema.

Changes in Visual Field Index After Cataract Extraction

PURPOSE: To investigate the changes of visual field index (VFI) compared with mean deviation (MD) and pattern standard deviation (PSD) before and after cataract surgery. METHODS: The present study included 77 eyes of 77 patients who were diagnosed with both glaucoma and cataracts and underwent cataract surgery. Preoperative and postoperative VFI, MD, and PSD were examined. Lens opacity type was classified as cortical, nucleosclerosis, or posterior subcapsular opacity (PSCO), and the MD, PSD, and VFI were compared before and after cataract surgery. RESULTS: Preoperative and postoperative MD were -13.64+/-8.97, -11.94+/-9.67(p=0.113), PSD were 6.18+/-3.30, 5.91+/-3.31(p=0.344), and VFI were 67.00+/-33.43, 70.55+/-33.19(p=0.440), respectively. MD showed statistically significant difference in cortical and PSCO type before and after cataract surgery. PSD (p=0.025) and VFI (p=0.020) showed a statistically significant difference in cortical type. CONCLUSIONS: VFI is an effective parameter to monitor the progression of glaucoma in cataract patients with nucleosclerosis and PSCO, but has limitations in cataract patients with cortical opacity.

Vision-Correction Effect of RGP Contact Lens in Patients With Corneal Opacity Following Repaired Corneal Perforations

PURPOSE: To investigate the effect of rigid gas permeable (RGP) contact lenses in patients with corneal scar and opacity following repair of corneal perforations. METHODS: A total of 10 eyes from 10 patients undergoing repair of corneal perforating injuries and fitted with RGP contact lenses were examined in the present study. The mean postoperative 3-month visual acuities, refraction, corneal topography, keratometry, best corrected visual acuities with spectacles and RGP lenses at an average of postoperative 3 months were evaluated. RESULTS: Eight eyes had corneal opacities at the central and 2 eyes at the peripheral portion. Four patients had previous cataract surgery or cataract surgery with intraocular lens insertion due to traumatic cataract. The mean postoperative 3-month LogMAR visual acuity was 1.14 +/- 0.53. Corneal topography showed irregular astigmatism in all patients and the mean keratometric astigmatism was 4.03 +/- 4.06 diopters. The mean best corrected LogMAR visual acuities with spectacles was 0.91 +/- 0.64 and with the RGP contact lens was 0.25 +/- 0.35. A comparative analysis of improvement in visual acuity with the RGP contact lens over spectacle correction was found to be statistically significant (p = 0.005). Patients wore the lenses for more than 6 hours daily for the mean follow-up period (12.10 +/- 7.80 months). CONCLUSIONS: In patients with corneal scar and opacity following repair of corneal perforations, RGP contact lens fitting should be considered first before surgical corrections such as keratoplasty.

Two Cases of Acute Retinal Necrosis Treated With Systemic Antiviral Drugs and Intravitreal Antiviral Injections

PURPOSE:To report the use of intravitreal antiviral injections as adjunctive therapy in the managementof two immunocompetent patients with acute retinal necrosis. CASE SUMMARY: We performed two or three intravitreal injections of gancyclovir (2,000 microg/0.05 ml) on two patients (two eyes) with acute retinal necrosis resistant to intravenous acyclovir therapy (1,500 mg/m2/day). Both patients received intravitreal antiviral injections for the treatment of retinitis that progressed despite standard intravenous acyclovir therapy. The retinitis resolved, and visual acuity improved after 18 months of follow-up in both cases. CONCLUSIONS: Intravitreal antiviral injections may be a safe and efficacious adjunctive therapy in the management of patients with acute retinal necrosis resistant to intravenous acyclovir therapy.

Three Cases of Atypical Harada's Disease

PURPOSE: We present three cases of atypical Harada's disease that exhibited different clinical courses. CASE SUMMARY: (Case 1) A 56-year-old male initially presented with typical findings of Harada's disease accompanied by exudative retinal detachment of the left eye. However, he did not show any signs and symptoms of Harada's disease in his right eye for 4 years. (Case 2) A 73-year-old male came to our clinic complaining of decreased visual acuity in both eyes with headache and tinnitus. Fundoscopic findings showed bilateral annular choroidal detachment but no evidence of exudative retinal detachment. The same result was obtained on remission. (Case 3) A 53-year-old female presented with decreased visual acuity in both eyes with headache and tinnitus. Fundoscopic findings showed severe choroidal folds instead of exudative retinal detachment, which was observed in 2 other remissive cases. CONCLUSIONS: We report 3 cases of atypical Harada's disease that did not present with bilateral exudative retinal detachment. Ophthalmologists should know that Harada's disease can exhibit diverse clinical courses.

The Relationship Between Asphericity and Visual Acuity After Wearing Reverse-Geometry Lens

PURPOSE:To report the change of corneal asphericity and the relationship between asphericity and visual acuity after wearing the reverse-geometry lens. METHODS: The authors reviewed out-patient records of 37 consecutive patients wearing reverse-geometry lenses. The patients were followed up from July 2004 to December 2007. The unaided visual acuity (VA), spherical equivalent (SE) and asphericity before and after wearing the lens were compared. The relationship of SE and final VA, initial astigmatism and final VA, and asphericity and final VA was also analyzed. In addition, the relationship between the increment of VA and asphericity was determined. RESULTS: VA and SE improved and the asphericity decreased after wearing the lens (p<0.05). There was high correlation between the spherical equivalent and final visual acuity (p<0.001), and no correlation between asphericity and final visual acuity (p=0.358) was observed. However, the lower the initial asphericity, the greater the increment of visual acuity observed (p=0.048). CONCLUSIONS: Initial corneal asphericity can be a predictor of increment of VA after wearing reverse-geometry lenses.

A Case of Retinal Detachment Surgery in Albinism Patient

PURPOSE: To report a case of retinal detachment surgery in a patient with oculocutaneous albinism. CASE SUMMARY: A 44-year-old man visited our clinic complaining of decreased visual acuity in his left eye. His best corrected visual acuity was hand movement in his left eye, and rhegmatogenous retinal detachment involving the macula at the superior temporal site was found. We performed pars plana vitrectomy and attempted to reattach the retina using endolaser photocoagulation; however, the laser burn was not made, and we failed to reattach the retina. At that point, we carried out cryopexy around the retinal tear, and injected silicone oil into the vitreous cavity. Ten months after surgery, his best corrected visual acuity was 0.06, and there was no recurrent retinal detachment or proliferative vitreoretinopathy. CONCLUSIONS: In patients with albinism with melanin deficiency, cryopexy is more useful than laser photocoagulation for retinal detachment surgery.

A Case of Occlusive Retinal Vasculitis in Churg-Strauss Syndrome

PURPOSE: To report a case of occlusive retinal vasculitis in Churg-Strauss syndrome. CASE SUMMARY: A-48-year-old man visited our clinic complaining of suddenly decreased visual acuity in the left eye. Two months previously he had an operation for sinusitis, and he had been taking medications for asthma. In the initial examination, his best corrected visual acuity was 0.02 in the left eye. Fundus examination showed whitish, multiple, diffuse ischemic lesions around the posterior pole and slightly engorged retinal veins in the left eye. Fluorescein angiography showed delayed choroidal filling and delayed arteriovenous transit time in the left eye, but no apparently visible obstruction site. The eosinophil count was elevated to 65% in the white blood cell differentiated count, and perinuclear antineutrophil cytoplasmic antibodies (ANCA) with antimyeloperoxidase specificity (MPO-ANCA) was increased, but a chest X-ray was normal. Eosinophil infiltrations in the mucosa of the paranasal sinus were found, and peripheral neuropathy was found in a nerve conduction study. Hence, we diagnosed the patient with Churg-Strauss syndrome accompanied by occlusive retinal vasculitis, and started steroid therapy. Thirty days later after steroid therapy, the best corrected visual acuity of the left eye was 0.4. CONCLUSIONS: In patients with occlusive retinal vasculitis, we need to consider systemic diseases, such as Churg-Strauss syndrome.

Hydrogen Peroxide-Induced Cell Death in a Human Retinal Pigment Epithelial Cell Line, ARPE-19

The loss of retinal pigment epithelium (RPE) with aging is related to age-related macular degeneration (AMD). This study was conducted to investigate the mechanism of hydrogen peroxide (H2O2) induced cell death in a human retinal pigment epithelial cell line, ARPE-19. Hydrogen peroxide was added at different concentrations to ARPE-19 cells and cultured. The cytotoxicity was assayed by mitochondrial function using 3- (4, 5-dimethylthiazol-2-yl) -2, 5-diphenyl tetrazolium bromide (MTT) testing. The patterns of cell damage were assessed using an acridine orange-ethidium bromide differential staining method, in situ end labeling (ISEL) assay and transmission electron microscopy (TEM). Catalase, a major antioxidant, was used to prevent cell death. The cleavage of procaspase 3 and poly (ADP-ribose) polymerase (PARP) was determined by western blot analysis. Hydrogen peroxide significantly induced cell death in ARPE-19 cells, whereas pretreatment of the cells with catalase prevented cell death. Application of the ISEL assay and acridine orange/ethidium bromide staining demonstrated that the H2O2-induced cell death occurred by an apoptotic mechanism at lower concentrations of H2O2 (400, 500, 600 microM), whereas higher concentrations of H2O2 induced necrosis rather than apoptosis. Caspase 3 was associated with the apoptotic pathway in human RPE cell death. Western blot analysis confirmed caspase 3 activation and cleavage of substrate proteins in ARPE-19 cells treated with an H2O2 concentration of 600 microM. These results indicate that treatment with H2O2 induces apoptotic and necrotic cell death in ARPE-19, and that caspase 3 is associated with apoptotic cell death. Therefore, H2O2 may induce the destruction of RPE cells in AMD by the combined effects of apoptosis and necrosis.

The Visual Prognosis in Marfan Syndrome with Ectopia Lentis

PURPOSE: To assess the clinical characteristics, indications of operation, operative methods and visual prognosis in Marfan syndrome with ectopia lentis. METHODS: Medical records of 13 patients (24 eyes) operated due to ectopia lentis were retrospectively analyzed. We evaluated family history, chief complaints, refraction, intraocular lens power, preoperative and postoperative visual acuity, visual prognosis according to the operative methods using one way ANOVA statistically, and postoperative complications. RESULTS: The range of age at the time of operation was 5~51 years old (mean age 19.4 years old). 6 men, 7 women, 9 had family history. Decreased visual acuity (8 patients) was the main cause to visit hospital, and the knitting the brow (4), the discovery during routine ocular examination (3), strabismus (2), the difficulty in near work (2), monoocular diplopia (1). The ranges of preoperative best corrected visual acuity were 0.01 to 0.3. Postoperative visual acuity was 0.15 to 0.9. In all cases visual acuities increased. High myopia (more than .6 diopter) was seen in 13 eyes, but the ranges of the axial length were normal. The operation was performed with pas plana approach in 7 eyes, by extracapsular cataract extraction in 12 eyes, and by intracapsular cataract extraction in 5 eyes. Intraocular lenses were inserted in 16 eyes. No statistically differences were seen in postoperative best-corrected visual acuity. Preretinal hemorrhages was seen in only one eye postoperatively, soon disappeared and other complications was not seen. CONCLUSIONS: The most common cause of operation in ectopia lentis was the decreased visual acuity. The cause of high myopia in ectopia lentis was spherophakia due to zonulysis, not axial myopia. The visual prognosis was good in all patients, and no differences was seen respective of operation methods.