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Caution needed when treating high myopes with lens-based refractive surgery
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PARIS — When treating highly myopic eyes with lens-based refractive surgery, surgeons should be aware of the potential posterior segment complications involved.
In addition, clinicians may want to avoid multifocal implants, which can make management of complications significantly more difficult, according to a retina specialist speaking here at the meeting of the French Society of Ophthalmology.
While retinal complications with laser refractive surgery are rare, lens-based refractive surgery can expose highly myopic eyes to infrequent but potentially severe posterior segment complications, such as retinal detachment, endophthalmitis and expulsive hemorrhage.
"These patients should be made aware of the risk, and surgeons should also consider safer alternatives," Jean-François Korobelnik, of Bordeaux University Hospital, said.
In a prospective study currently ongoing in Bordeaux and four other centers in France, 150 highly myopic patients who underwent lens-based refractive surgery are being followed over 5 years. So far, it appears that the risk of retinal detachment is higher than in phakic eyes and increases with time, age and YAG rate.
Dr. Korobelnik also said that the surgical management of retinal detachment is made more difficult by multifocal implants, due to the problems of visualizing the ocular fundus. In consideration of this, it might be better to avoid multifocals in highly myopic patients, he said.