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Incidence of vitreous-retinal modifications
after phacoemulsification in high myopia a
prospective medium term study
F. Fasce, M. Rossi, A. Spinelli, G. Bolognesi, P.
Mauceri Ophthalmology Day Surgery Unit San
Raffaele Scientific Institute Milan Italy
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Aim of the study
To investigate the modifications of
vitreous-retinal compartment after successful
phacoemulsification for cataract in high myopia.
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Methods

• Inclusion criteria
• High myopia AXLgt 27.0 D
• Cataract grade ? 2
• Patients scheduled for cataract surgery

• Study design
• Prospective 1 year follow-up
• 118 eyes of 100 patients
• 34 males/66 females
• Age 6110.4 ys
• AXL 27.2-35.4 mm ( Mean 29.6 2.39 mm)
• Myopia -15.44 6.89 dioptres

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Methods

• Parameters evaluatedFollow up 15 days, 6 and 12
  months
• BCVA
• Peripheral retinal degeneration (3 mirrors
  Goldmann lens)
• Posterior vitreous detachment, ultrasonografic
  B-Scan examination (ECO Cinescan)
• Anatomical macular abnormalities (Stratus OCT,
  Zeiss and OCT-SLO, OTI)
• Surgical parameters (US time, US power)

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Methods

• Surgical procedure
• Clear corneal 3.2 mm incision
• Divide and conquer technique
• IOL implant with 2.8 mm injector

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Results

• Surgical parameters
• US time 78.9 sec sd 32.4
• US power 19.9 sd 7.3
• Surgery time 10 min sd 1.3

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Results
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Results

• Postoperative findings
• Posterior vitreous detachment 100
• Macular abnormalities 51.7
• Retinal tears 0.84
• Peripheral holes 0.84
• Retinal detachment 0.84
• Posterior capsule fibrosis 1.6
• (NDYag-laser capsulotomy)

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Posterior vitreous detachment
Preoperative 89.8
Postoperative 100
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Macular abnormalities
Postoperative 51.7
Preoperative 48.3
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Retinal detachment 1 case

• No B-scan preoperative evidence of PVD
• AXL 29.54 mm
• Onset 1 year after surgery
• Male, 48 years
• No ophthalmoscopic evidence of peripheral
  degeneration
• Myopic macular degeneration

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Discussion

• The results suggest that anatomical vitreous
  modifications induced by phacoemulsification can
  lead to minimal retinal changes, but most serious
  complication, the retinal detachment, is uncommon
  if the technique is correctly performed.