Refractive lens exchange combined with pars plana vitrectomy to correct high myopia.
OBJECTIVE
To describe the results of refractive lens exchange (RLE) combined with simultaneous pars plana vitrectomy (PPV) in the management of severe myopia.


METHODS
This retrospective study comprised 14 eyes of eight patients who had RLE to treat myopia of -19.0+/-5.4 diopters (D). Phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and standard three-port vitrectomy were performed. Mean postoperative follow-up time was 30 months (range 12-49).


RESULTS
The postoperative best-corrected visual acuity (BCVA) was 0.68+/-0.23 compared to 0.37+/-0.24 preoperatively. There was no postoperative decrease in visual acuity in any eye. Mean postoperative spherical equivalent was -0.7 D (+/-1.6). At 30 months mean follow-up time, the spherical equivalents of nine eyes (64.3%) were within +/-1 D of emmetropia. There was no significant change in astigmatism due to operative procedures. During the 30 months follow-up period three eyes (21.4%) required neodymium : yttrium-aluminium-garnet (Nd : YAG) capsulotomy for posterior capsule opacification. No retinal detachments or cases of cystoid macular oedema (CME) were observed during the follow-up.


CONCLUSIONS
RLE was effective in correcting severe myopia. The simultaneously performed PPV may reduce the risk of postoperative retinal detachment. This was a pilot study, to draw definitive conclusions a prospective study has to be initiated.
Uhlmann
S
S
Department of Ophthalmology, University of Leipzig, Leipzig, Germany. scos@medizin.uni-leipzig.de
Wiedemann
P
P
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D018918:Phacoemulsification; D012163:Retinal Detachment / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*