Cataract surgery appears safe in microphthalmic eyes

This retrospective study found that while microphthalmic eyes undergoing cataract surgery and requiring high IOL power are rare, the procedure was safe in these patients, with satisfactory clinical outcomes and a low complication rate.

While the incidence of complications in these eyes is much higher than in normal eyes, 51% of cases had other associated ocular diseases and 90% of all eyes were complication free.

The study included 39 eyes that underwent phacoemulsification with IOL implantation at one of two locations during a five-year period. All eyes had axial length < 20.9 mm and required a high IOL power (≥ 30 or ≥ 35 D for anterior or posterior chamber fixation, respectively), with no history of previous ocular surgery.

There were no serious intraocular adverse events. Complications included iris prolapse, endothelial corneal touch, retinal detachment (one case), postop inflammation and cystoid macular edema. 

Postop CDVA was logMAR 0.30 or better in 24 eyes (62%), and only three eyes had worse vision. Ten microphthalmic eyes (26%) presented with associated congenital or hereditary pathology, and had worse visual outcomes (P < 0.0001).

The authors conclude that apart from cases with refractive amblyopia, visual outcomes were satisfactory in patients who did not suffer from ocular congenital or hereditary ocular disorders.