Clinical Characteristics and Outcomes of Cataract Surgery in Highly Myopic Koreans
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초록
Purpose: To evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects. Methods: We retrospectively reviewed the medical records of 694 eyes of 694 patients who underwent cataract surgery. The case group included 347 eyes of 347 patients whose axial lengths (AXL) were ≥26.00 mm, and the control group included 347 eyes of 347 patients with AXL between 22.00 and 25.99 mm. Cataract density was determined preoperatively using the Pentacam Scheimpflug imaging system. We compared age at operation,cataract type, coexisting disease, visual prognosis, and complications. Results: The mean age at the time of the operation was 59.60 ± 12.28 years in the case group and 67.47 ± 11.36years in the control group. The case group had a larger proportion of nuclear cataracts and posterior subcapsular cataracts (PSC), 40.63% and 26.22%, respectively, versus 25.07% and 11.82%, respectively, in the control group. Postoperative corrected visual acuity showed a negative correlation with AXL (R2 = 0.172), and severe funduscopic findings were related to poor visual prognosis (p = 0.05). The incidence of retinal detachment in the case group after cataract surgery was 1.72%, compared with 0.28% in the control group. Conclusions: Highly myopic eyes tend to develop cataracts earlier than normal eyes and to have a higher prevalence of coexisting disease and complications, such as retinal detachment. Nuclear cataracts and PSC were more common in the highly myopic group. Poor visual prognosis was associated with longer axial length and retinal myopic degeneration.
Abstract
Purpose: To evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects. Methods: We retrospectively reviewed the medical records of 694 eyes of 694 patients who underwent cataract surgery. The case group included 347 eyes of 347 patients whose axial lengths (AXL) were ≥26.00 mm, and the control group included 347 eyes of 347 patients with AXL between 22.00 and 25.99 mm. Cataract density was determined preoperatively using the Pentacam Scheimpflug imaging system. We compared age at operation,cataract type, coexisting disease, visual prognosis, and complications. Results: The mean age at the time of the operation was 59.60 ± 12.28 years in the case group and 67.47 ± 11.36years in the control group. The case group had a larger proportion of nuclear cataracts and posterior subcapsular cataracts (PSC), 40.63% and 26.22%, respectively, versus 25.07% and 11.82%, respectively, in the control group. Postoperative corrected visual acuity showed a negative correlation with AXL (R2 = 0.172), and severe funduscopic findings were related to poor visual prognosis (p = 0.05). The incidence of retinal detachment in the case group after cataract surgery was 1.72%, compared with 0.28% in the control group. Conclusions: Highly myopic eyes tend to develop cataracts earlier than normal eyes and to have a higher prevalence of coexisting disease and complications, such as retinal detachment. Nuclear cataracts and PSC were more common in the highly myopic group. Poor visual prognosis was associated with longer axial length and retinal myopic degeneration.
참고문헌 (31)
- Wang TJ, "Changes of the ocular refraction among freshmen in National Taiwan University between 1988 and 2005", Eye(Lond), 23, pp.1168~1169 (2009)
- 이상준, "2002년 부산, 울산 및 경상남도 19세 남자의 근시 유병률", 대한안과학회지, 50(9), pp.1392~1403 (2009), 대한안과학회
- Hyung SM, "Optic disc of the myopic eye:relationship between refractive errors and morphometric characteristics", Korean J Ophthalmol, 6, pp.32~35 (1992)
- Suzuki Y, "Risk factors for open-angle glaucoma in a Japanese population:the Tajimi Study", Ophthalmology, 113, pp.1613~1617 (2006)
- Mayama C, "Myopia and advanced-stage open-angle glaucoma", Ophthalmology, 109, pp.2072~2077 (2002)
- Lee YA, "Association between high myopia and progression of visual field loss in primary open-angle glaucoma", J Formos Med Assoc, 107, pp.952~957 (2008)
- Perkins ES, "Cataract:refractive error,diabetes,and morphology", Br J Ophthalmol, 68, pp.293~297 (1984)
- Weale R, "A note on a possible relation between refraction and a disposition for senile nuclear cataract", Br J Ophthalmol, 64, pp.311~314 (1980)
- Brown NA, "Cataract:the relation between myopia and cataract morphology", Br J Ophthalmol, 71, pp.405~414 (1987)
- Praveen MR, "A study to explore the risk factors for the early onset of cataract in India", Eye(Lond), 24, pp.686~694 (2010)
- Lim R, "Refractive associations with cataract:the Blue Mountains Eye Study", Invest Ophthalmol Vis Sci, 40, pp.3021~3026 (1999)
- Wong TY, "Refractive errors and incident cataracts:the Beaver Dam Eye Study", Invest Ophthalmol Vis Sci, 42, pp.1449~1454 (2001)
- Tosi GM, "Phacoemulsification without intraocular lens implantation in patients with high myopia:long-term results", J Cataract Refract Surg, 29, pp.1127~1131 (2003)
- Mehdizadeh M, "Prevalence of cataract type in relation to axial length in subjects with high myopia and emmetropia in an Indian population", Am J Ophthalmol, 146, pp.329~330 (2008)
- Chen SN, "Nuclear sclerotic cataract in young patients in Taiwan", J Cataract Refract Surg, 29, pp.983~988 (2003)
- Kirkwood BJ, "Repeatability and validity of lens densitometry measured with Scheimpflug imaging", J Cataract Refract Surg, 35, pp.1210~1215 (2009)
- Kim JS, "Clinical application of a Scheimpflug system for lens density measurements in phacoemulsification", J Cataract Refract Surg, 35, pp.1204~1209 (2009)
- Tsai CY, "Visual outcomes and associated risk factors of cataract surgeries in highly myopic Taiwanese", Ophthalmologica, 222, pp.130~135 (2008)
- Fernandez-Vega L, "Clear lens extraction for the correction of high myopia", Ophthalmology, 110, pp.2349~2354 (2003)
- Kubaloglu A, "Small incision clear lens extraction for correction of high myopia", Eur J Ophthalmol, 14, pp.1~6 (2004)
- Pucci V, "Clear lens phacoemulsification for correction of high myopia", J Cataract Refract Surg, 27, pp.896~900 (2001)
- Lee KH, "Long-term results of clear lens extraction for severe myopia", J Cataract Refract Surg, 22, pp.1411~1415 (1996)
- Ripandelli G, "Cataract surgery as a risk factor for retinal detachment in very highly myopic eyes", Ophthalmology, 110, pp.2355~2361 (2003)
- Ravalico G, "Retinal detachment after cataract extraction and refractive lens exchange in highly myopic patients", J Cataract Refract Surg, 29, pp.39~44 (2003)
- Jacobi FK, "Pseudophakic retinal detachment in high axial myopia", J Cataract Refract Surg, 23, pp.1095~1102 (1997)
- Colin J, "Retinal detachment after clear lens extraction for high myopia:seven-year follow-up", Ophthalmology, 106, pp.2281~2284 (1999)
- Alio JL, "The risk of retinal detachment in high myopia after small incision coaxial phacoemulsification", Am J Ophthalmol, 144, pp.93~98 (2007)
- Chylack LT Jr, "The Lens Opacities Classification System III.The Longitudinal Study of Cataract Study Group", Arch Ophthalmol, 111, pp.831~836 (1993)
- Micelli-Ferrari T, "Role of lipid peroxidation in the pathogenesis of myopic and senile cataract", Br J Ophthalmol, 80, pp.840~843 (1996)
- Zigler JS Jr, "Effects of lipid peroxidation products on the rat lens in organ culture:a possible mechanism of cataract initiation in retinal degenerative disease", Arch Biochem Biophys, 225, pp.149~156 (1983)
- Klein BE, "Assessment of cataracts from photographs in the Beaver Dam Eye Study", Ophthalmology, 97, pp.1428~1433 (1990)