Cataract surgery in high myopes does not appear to increase the risk of retinal detachment

As interesting as this original article is, it was even more interesting to see the data presented in detail by the brilliant clinician, Irmingard M. Neuhann, MD of the Tubingen University Eye Hospital, Tubingen, Germany. The essence is that with modern cataract surgery the incidence of retinal detachment does not appear to go up over baseline for the high to extreme axial myope.

This retrospective case series included 1,519 highly myopic patients who underwent cataract surgery. Follow-up was at least 12 months for 93.4 percent of eyes, and more than 24 months for 84 percent of eyes. The incidence of retinal detachment was 1.5 percent to 2.2 percent, which is within the range of the reported rates of idiopathic retinal detachment in high myopia.

And the addition of a Nd:YAG laser posterior capsulotomy (43.2 percent or 1,018 patients had capsulotomy) at a later date did not increase the retinal detachment rate to a level of statistical significance. Also, for patients in whom prophylactic treatment of problem areas in the far periphery was carried out prior to cataract surgery, the rate of retinal detachment did not go down, but was actually higher; probably indicating a more "at risk" sub-group.