title: Outcomes of phacoemulsification and intraocular lens implantation in microphthalmos and nanophthalmos.
abstract: OBJECTIVE
  To evaluate the outcomes of phacoemulsification and intraocular lens (IOL) implantation in microphthalmos and nanophthalmos.
  
  
  METHODS
  Moorfields Eye Hospital, London, United Kingdom.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Eyes with an axial length (AL) less than 21.0 mm had elective phacoemulsification and IOL implantation.
  
  
  RESULTS
  One hundred three eyes (63 patients) were enrolled. The median AL was 20.65 mm (interquartile range [IQR], 20.26 to 20.86) and the median follow-up, 6.3 months. Complications occurred in 16 cases (15.5%). Zonular dehiscence, severe uveitis, and aqueous misdirection accounted for the majority of complications. Complication rates were 6 (7.3%) of 82 cases with an AL from 20.0 to 21.00 mm and 10 (47.6%) of 21 cases with an AL less than 20.0 mm (P=.0001). Only AL (odds ratio [OR], 0.52 per mm; P≤.0005) and abnormal intraocular pressure (IOP) of 22 mm Hg or more or on topical IOP control (OR, 10.1; P=.001) were significant independent risk factors for complications. For the cohort after adjusting for abnormal IOP, an AL less than 20.5 mm was associated with a 4 times higher odds of any complication (P=.028), an AL less than 20.0 mm was associated with a 15 times higher odds of any complication (P≤.0005), and an AL less than 19.00 mm was associated with a 21 times higher odds of any complication (P≤.0005).
  
  
  CONCLUSIONS
  Phacoemulsification and IOL implantation in microphthalmos/nanophthalmos was challenging but appears safer than previously reported. A shorter AL and abnormal IOP were significant risk factors for complications.
authors.affiliation: From Moorfields Eye Hospital Foundation Trust (Day, MacLaren, Bunce, Stevens, Foster), University College London Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the London School of Hygiene and Tropical Medicine (Bunce), London; and the NIHR Biomedical Research Centre at Oxford University Hospitals NHS Trust and the University of Oxford (MacLaren), United Kingdom. Electronic address: alex.day@ucl.ac.uk.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Day
authors.affiliation: From Moorfields Eye Hospital Foundation Trust (Day, MacLaren, Bunce, Stevens, Foster), University College London Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the London School of Hygiene and Tropical Medicine (Bunce), London; and the NIHR Biomedical Research Centre at Oxford University Hospitals NHS Trust and the University of Oxford (MacLaren), United Kingdom.
authors.forename: Robert E
authors.initials: RE
authors.lastname: MacLaren
authors.affiliation: From Moorfields Eye Hospital Foundation Trust (Day, MacLaren, Bunce, Stevens, Foster), University College London Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the London School of Hygiene and Tropical Medicine (Bunce), London; and the NIHR Biomedical Research Centre at Oxford University Hospitals NHS Trust and the University of Oxford (MacLaren), United Kingdom.
authors.forename: Catey
authors.initials: C
authors.lastname: Bunce
authors.affiliation: From Moorfields Eye Hospital Foundation Trust (Day, MacLaren, Bunce, Stevens, Foster), University College London Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the London School of Hygiene and Tropical Medicine (Bunce), London; and the NIHR Biomedical Research Centre at Oxford University Hospitals NHS Trust and the University of Oxford (MacLaren), United Kingdom.
authors.forename: Julian D
authors.initials: JD
authors.lastname: Stevens
authors.affiliation: From Moorfields Eye Hospital Foundation Trust (Day, MacLaren, Bunce, Stevens, Foster), University College London Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (Day, MacLaren, Bunce, Foster), the London School of Hygiene and Tropical Medicine (Bunce), London; and the NIHR Biomedical Research Centre at Oxford University Hospitals NHS Trust and the University of Oxford (MacLaren), United Kingdom.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Foster
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058452:Axial Length, Eye / Q000002:abnormalities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008850:Microphthalmos / Q000601:surgery*; D008875:Middle Aged; D016017:Odds Ratio; D018918:Phacoemulsification; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D055815:Young Adult