Refractive Lens Exchange Combined with Pars Plana Vitrectomy to Correct High Myopia

Purpose: To describe the results of refractive lens exchange (RLE) combined with simultaneous pars plana vitrectomy (PPV) in the management of severe myopia.

Methods: This retrospective study comprised 14 eyes of eight patients who had RLE to treat myopia of -19.0+/-5.4 diopters (D). Phacoemulsification, posterior chamber intraocular lens (IOL) implantation, and standard three-port vitrectomy were performed. Mean postoperative follow-up time was 30 months (range 12-49).

Results: The postoperative best-corrected visual acuity (BCVA) was 0.68+/-0.23 compared to 0.37+/-0.24 preoperatively. There was no postoperative decrease in visual acuity in any eye. Mean postoperative spherical equivalent was -0.7 D (+/-1.6). At 30 months mean follow-up time, the spherical equivalents of nine eyes (64.3%) were within +/-1 D of emmetropia. There was no significant change in astigmatism due to operative procedures. During the 30 months follow-up period three eyes (21.4%) required neodymium : yttrium-aluminium-garnet (Nd : YAG) capsulotomy for posterior capsule opacification. No retinal detachments or cases of cystoid macular oedema (CME) were observed during the follow-up.

Conclusion: RLE was effective in correcting severe myopia. The simultaneously performed PPV may reduce the risk of postoperative retinal detachment. This was a pilot study, to draw definitive conclusions a prospective study has to be initiated.