Abstract:

Objective To evaluate the macular changes and recovery of visual acuity in highly myopic patients after phacoemulsification. Methods One hundred and five patients (150 eyes) with cataract were divided into highly myopic group (group A, 56 patients, 80 eyes) and non-highly myopic group(group B, 49 patiens, 70 eyes), and phacoemulsification and intracapsular implantation of foldable intraocular lens were performed. In all patients, uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were measured, minimal foveal thickness (MFT) and total macular volume (TMV) were determined with optical coherence tomograghy before operation and 1 week, 1 month and 3 months after operation, and accumulated energy complex parameter (AECP) was also calculated. Results UCVA, BCVA and TMV at different time points after operation were significantly higher than those before operation in group A and group B (P<0.01), while there was no significant difference between MFT before operation and those at different time points after operation in two groups (P>0.05). There was no significant difference between MFT before operation and those at different time points after operation in patients with high AECP and those with low AECP in group A and group B (P>0.05), TMV at different time points after operation were significantly higher than that before operation in patients with high AECP and those with low AECP in group A and group B (P<0.01), and there was no significant difference in the changes of MFT or TMV between patients with high AECP and those with low AECP at the time points of 1 week, 1 month and 3 months after operation in group A and group B (P>0.05). One eye had a shallow detachment of the neuroretina from retinal pigment epithelium in nasally inferior part of the macular area in group A, and 3 eyes in group A and 1 eye in group B had subtle intraretinal cystoid abnormalities. Conclusion Highly myopic patients may have a good recovery of visual acuity after phacoemulsification, with no macular edema, no significant change in MFT, and an increase in TMV after operation. The actual phaco power has no significant influence on macular area in highly myopic patients.

Key words: high myopia, cataract, phacoemulsification, optic coherence tomography