Phacoemulsification improves vision outcomes after cataract surgery
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Vision outcomes showed improvement in patients with high myopia after phacoemulsification in cataract surgery, according to a study published in Journal of Cataract and Refractive Surgery.
This systematic review and meta-analysis was conducted by researchers at Fudan University, China, to evaluate visual improvements and complications of phacoemulsification.
Of the 28 studies included in the analysis, nine evaluated corrected distance visual acuity before and after phacoemulsification, showing significant improvement from preoperative visual acuity of about 0.96 logMAR to postoperative visual acuity of about 0.35 logMAR (95% CI, -0.67 to -0.54 logMAR).
“Eyes with poorer preoperative visual acuity and longer axial length were associated with a greater improvement of corrected distance visual acuity,” the authors wrote.
However, researchers found that phacoemulsification-related complications occurred more frequently in highly myopic eyes.
“Because of the complicated vitreomacular status, there is often a mismatch between apparent lens density and visual acuity resulting in no significant improvement in visual acuity after cataract surgeries in some cases,” the authors said. “In consequence, it should be evaluated and balanced whether the potential gains are worth undertaking the high risks of the surgery.”
Perspective
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Cataract surgery is one of the most common surgical procedures performed within the U.S. Even with a high safety profile, it does not come without risk. High myopia in patients considering cataract surgery increases that risk. As myopia continues to become more prevalent, we will find ourselves having the discussion of cataract surgery more frequently with this subset of patients. This study summarizes some of the complications that can arise in those with high myopia, including retinal detachments and posterior capsular rupture among others, and comparing them to the percentage known to occur in the general population, with a majority showing an increase in incidence.
A key takeaway is to note that complications from surgery can arise not only a day or a week from surgery, but also months to years. This is crucial to be aware of to properly educate patients on visual expectations and to alert them to signs and symptoms that warrant an exam sooner rather than later. Weighing risks and benefits to any surgical procedure is always warranted. In knowing that, highly myopic individuals still have a good chance of significant, life-changing visual recovery after cataract extraction.
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