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Refractive lens exchange in high myopia: long term follow up

¹ Department of Ophthalmology, Waterford Regional Hospital, Waterford, Republic of Ireland
² Department of Ophthalmology, Aut Even Hospital, Kilkenny and Waterford Eye Clinic, Waterford, Republic of Ireland

Correspondence to:
Correspondence to:
Noel Horgan
Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Republic of Ireland: noelhorg{at}hotmail.com

ABSTRACT
Aim: To establish long term outcomes and incidence of complications following refractive lens exchange (RLE) for the correction of high myopia.

Methods: Operative and postoperative records of 62 cases of small incision phacoemulsification RLE performed in 37 patients over an 11 year period, by a single surgeon, were reviewed. In addition, patients were recalled for a follow up examination, which included dilated retinal examination with scleral indentation.

Results: Two cases (3.2%) of retinal detachment occurred at intervals of 2 months and 5 months following uncomplicated RLE procedures. A posterior chamber intraocular lens was inserted in 46 eyes (74%). YAG laser posterior capsulotomy was performed in 38 of 62 eyes (61%) and did not represent a risk for retinal detachment.

Conclusion: Refractive lens exchange results in rapid and predictable improvement in unaided vision in patients with high myopia. However, the risks of sight threatening complications inherent in any intraocular procedure underlie the need for appropriate patient selection.

Abbreviations: CLE, clear lens extraction; IOL, intraocular lens; LASIK, laser in situ keratomileusis; MMD, myopic macular degenerative changes; PRK, photorefractive keratectomy; RLE, refractive lens exchange; UVA, unaided visual acuities

Keywords: myopia; lens exchange

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