Retinal detachment after clear lens extraction in 41 eyes with high axial myopia

Purpose: Clear lens extraction is a surgical procedure to correct high axial myopia. The authors explain how this technique may lead to serious vitreoretinal complications. Methods: The study included 41 eyes of 39 patients aged 25 to 58 years (mean, 37.5 years) with high axial myopia (14-29 diopters; mean, 19.5 diopters) operated on for retinal detachment after clear lens extraction. Retinal detachment occurred 1 month to 4 years after lens extraction, except for two eyes that also had intraoperative choroidal hemorrhages. Results: Twenty-six of the 41 eyes had undergone 360 degrees prophylactic retinopexy on pre-equatorial areas; in four eyes, the retinal breaks occurred along the edge of the prior circumferential photocoagulation. Seventeen eyes exhibited proliferative vitreoretinopathy of various grades. The retina was reattached in 36 eyes. Only nine eyes achieved final visual acuity of 20/60 or better. Conclusions: Although the authors do not report the actual incidence of retinal detachment after clear lens extraction, they indicate that potentially blinding complications can occur after this surgical procedure, despite prophylactic treatments.