Cataract surgery in small adult eyes

Br J Ophthalmol. 2014 Sep;98(9):1261-5. doi: 10.1136/bjophthalmol-2013-304579. Epub 2014 Apr 23.

Abstract

Aim: To evaluate the clinical outcomes of phacoemulsification cataract surgery in microphthalmos.

Methods: Retrospective consecutive case series of eyes with axial length <20.9 mm, and requiring a high intraocular lens (IOL) power (≥30 or ≥35 dioptres for anterior or posterior chamber fixation, respectively), with no history of previous ocular surgery, and undergoing planned phacoemulsification cataract surgery with IOL implantation at Moorfields Eye Hospital was investigated to observe the incidence of intraoperative and postoperative complications.

Results: During a 5-year study period, 47 of 22,093 eyes were treated in two locations (0.21%). Thirty-nine eyes met the study inclusion criteria. No serious intraoperative adverse events were recorded. Severe postoperative complications (retinal detachment and chronic postoperative uveitis) occurred in two cases. The postoperative corrected distance visual acuity (CDVA) was logMAR 0.30 or better in 24 eyes (62%), and only three eyes obtained worse vision. The overall ocular comorbitidy rate was 53%; 10 microphthalmic eyes (26%) presented with associated congenital or hereditary pathology, and had worse visual outcomes (p<0.0001).

Conclusions: Microphthalmic eyes requiring high IOL power are rare, and their presence is often associated with other ocular congenital or acquired disorders. Overall, the clinical outcomes were satisfactory and the surgical procedure affected by a low complication rate.

Keywords: Lens and Zonules; Treatment Surgery.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axial Length, Eye
  • Cataract / complications*
  • Comorbidity
  • Female
  • Humans
  • Lens Implantation, Intraocular / methods
  • Lenses, Intraocular
  • Male
  • Microphthalmos / complications*
  • Microphthalmos / pathology
  • Middle Aged
  • Phacoemulsification / adverse effects*
  • Phacoemulsification / methods
  • Postoperative Care / methods
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult