Small eyes have worse post-cataract surgery refractive results, higher complication rate

This retrospective review found that refractive predictability and postoperative outcomes were poorer in eyes with nanophthalmos compared to eyes with relative anterior microphthalmos and normal controls.

They reviewed the charts of 17 eyes with nanophthalmos, 29 eyes with relative anterior microphthalmos and 54 normal controls. Nanophthalmos was defined as a short axial length (< 20.5 mm) without ocular malformations. Relative anterior microphthalmos was defined as a corneal diameter ≤ 11 mm, an anterior chamber depth ≤ 2.2 mm and an axial length ≥ 20.5 mm, with no other macroscopic, morphologic malformations.

Prediction of postoperative refraction was poorer in nanophthalmos cases compared to controls. The Holladay 1 formula showed the best predictive results in the nanophthalmos group, while the SRK II formula was the least preferable.

The complication rate was higher in nanophthalmos compared to both microphthalmos and controls. Nanophthalmic eyes showed a higher occurrence rate of posterior capsule rupture (11.7 percent). However, the difference among the three groups for postoperative endothelial cell loss was not significant.

The authors conclude that due to the higher complication rate, surgeons should carefully assess the potential risks and pay close attention when planning corrective surgery for nanophthalmic eyes.