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The risk of retinal detachment in high myopia after small incision coaxial phacoemulsification.

Alio JL, Ruiz-Moreno JM, Shabayek MH, Lugo FL, Abd El Rahman AM

Vissum Instituto, Oftalmológico de Alicante, Alicante, Spain; Miguel Hernández University, Division of Ophthalmology, Medical School, Alicante, Spain.

PURPOSE: Report incidence and risk of retinal detachment (RD)after coaxial phacoemulsification in high myopic patients. DESIGN: Retrospective consecutive interventional study. METHODS: SETTING: Vissum-Instituto Oftalmologico de Alicante, Spain. PATIENT OR STUDY POPULATION: A total of 439 eyes from 274 high myopic patients with spherical equivalent (SE) >or= 6.00 diopters (D) or axial length >or= 26.00 mm. Mean age 62.2, axial length 27.88 +/- 2.11 mm (26.0 mm to 37.9 mm), SE -13.3 +/- 5.6 (-6.00 D to -46.0 D). MAIN OUTCOME MEASURES: Incidence of RD, vitreous loss, and neodymium yttrium aluminum garnet (Nd:YAG) capsulotomy were evaluated after surgery at one, three, six, and 12 months then annually with mean follow-up 61.5 +/- 29.6 months. RESULTS: Incidence of RD was 2.7% (12/439 eyes). In eyes with <or= 50 years of age was 3.65% (three eyes) compared with eyes with > 50 years of age was 2.52% (nine eyes). Cumulative risk of RD development by Kaplan-Meier analysis in all patients was 0.47%, 0.71%, 1.71%, 2.59%, and 3.28% at three, six, 15, 48, and 63 months until 105 months, respectively. In eyes <or= 50 years of age: the risk increases to 1.23% at three months and 4.46% at 63 months until 147 months, whereas eyes with > 50 years of age was 0.58% and 2.96% at six and 52 months until 118 months after cataract surgery, respectively. No significant correlation was found between the occurrence of RD and vitreous loss (P <or= .33) or Nd:YAG capsulotomy (P <or= .50 Chi-square test). CONCLUSIONS: The incidence of RD in high myopic patients after coaxial phacoemulsification is 2.7%. A trend toward an increased incidence and risk in patients younger than 50 years of age was detected in this study.

Published 2 July 2007 in Am J Ophthalmol, 144(1): 93-98.
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