Clear Lens Extraction for the Correction of Severe High Myopia: Seven-year Follow-up

ABSTRACT

PURPOSE: To evaluate the postoperative outcomes and complications 7 years after clear lens extraction (CLE) for the correction of high myopia. METHODS: The medical records of 23 eyes of 15 patients who had undergone CLE to correct myopia higher than -12 diopter and who could be followed up for more than 7 years were reviewed. A scleral tunnel incision and continuous curvilinear capsulorhexis were made, followed by phacoemulsification and posterior chamber intraocular lens implantation. Refractive error, visual acuity and postoperative complications were recorded. RESULTS: Mean follow-up was 98.2 (84~118) months. Posterior capsular opacification developed in 12 eyes (52.2%) and neodymium: YAG laser posterior capsulotomy was performed in 7 eyes. Retinal detachment developed in 3 eyes of 2 patients at 6 months, 34 months, and 9 years after CLE. At 7 years after CLE, the spherical equivalent (SE) of 14 (60.9%) of 20 eyes was within +/- 2 diopter of targeted refractive error. Shift to myopia occurred by 1 diopter compared to SE at 1 year after CLE. Best corrected visual acuity improved by 2 lines in 14 eyes (60.9%) and was 0.5 or better in 17 eyes (73.9%). CONCLUSIONS: CLE for correction of high myopia had good visual outcomes with acceptable predictability. However, long term follow-up revealed gradual increase of serious complications like retinal detachment, posterior capsular opacification, and myopic shift by 1 diopter between 1 year and 7 years after CLE.