Outcomes of phacoemulsification and intraocular lens implantation in microphthalmos and nanophthalmos.

Abstract

PURPOSE:

To evaluate the outcomes of phacoemulsification and intraocular lens (IOL) implantation in microphthalmos and nanophthalmos.

SETTING:

Moorfields Eye Hospital, London, United Kingdom.

DESIGN:

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: Alexander C Day, Robert E MacLaren, Catey Bunce, Julian D Stevens, Paul J Foster
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 39 Issue 1 Pg. 87-96 (Jan 2013) ISSN: 1873-4502 [Electronic] United States
• PMID: 23245362 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Axial Length, Eye (abnormalities)
• Female
• Follow-Up Studies
• Humans
• Intraocular Pressure
• Intraoperative Complications
• Lens Implantation, Intraocular
• Male
• Microphthalmos (surgery)
• Middle Aged
• Odds Ratio
• Phacoemulsification
• Postoperative Complications
• Retrospective Studies
• Risk Factors
• Tomography, Optical Coherence
• Tonometry, Ocular
• Treatment Outcome
• Young Adult