[Phacoemulsification for visual refraction on the clear lens. Apropos of 33 severely myopic eyes]. / Phakoémulsification à visée réfractive sur cristallin clair. A propos de 33 yeux myopes forts.

PURPOSE: To evaluate visual benefit, predictability and complications after clear lens phakoemulsification and posterior chamber implantation in highly myopic eyes. METHODS: Thirty-three highly myopic eyes were reviewed at a mean postoperative follow-up of 27 months. The mean age of the 19 patients was 31.04 +/- 5.51 years. The mean preoperative spherical equivalent was -19.50 +/- 7.0 D (-12 to -40 D). Preoperative best spectacle corrected visual acuity was compared with the last postoperative one. Postoperative spherical equivalent was compared with the desired value. All complications were reviewed. RESULTS: A mean visual benefit of 0.24 +/- 0.18 (decimal notation) was noted (p < 0.05). The mean postoperative spherical equivalent (-2.57 +/- 1.84 D) was not significantly different from the mean previous value (p = 0.75). Retinal detachment arose in the two eyes of the same patient (incidence of 6.1%). BSCVA decreased slightly in only one of the two eyes (0.1). The incidence of Nd-YAG capsulotomy was 30%. CONCLUSION: Clear lens phakoemulsification is an effective and predictable method for the correction of high myopia. Retinal detachment is the major complication of this technique, even if a severe decrease of the visual acuity is not usual.

[Indications for vitrectomy in the extraction of intraocular foreign bodies]. / Indications de la vitrectomie pour l'extraction des corps étrangers intra-oculaires.

Vitrectomy represents an important advance for the extraction of intra-ocular foreign bodies, a study of 20 cases emphasizing the advantages of the method. Pars plana vitrectomy was performed using Klöti's vitreous stripper; intra-ocular foreign bodies were extracted through the pars plana incision by a magnet or with forceps. The main indications of the technique are: posterior pole foreign bodies; old embedded metallic foreign bodies; foreign bodies with complications (traumatic cataract, vitreous hemorrhage, retinal detachment); non-magnetic oxidizable foreign bodies: these must be extracted under visual control with vitrectomy techniques, but complications and failure remain common. This technique also has its limits: extraction of non-oxidizable non-magnetic foreign bodies; foreign bodies attached to the ocular globe wall. These are preferably left in place. Vitreoretinal complications were the main reasons for failure in this study. Nevertheless, vitrectomy allows clearing of cloudy media, visualization, localization and extraction of foreign bodies under visual control through the pars plana, and reduction of complications.