Redefinition of High Myopia: The Relationship of Axial Length Measurement to Myopic Pathology and Its Relevance to Cataract Surgery

Phacoemulsification in eyes with extreme axial myopia

“…Similarly, a definition based on IOL power can include eyes with a normal AL but steep corneal curvatures, as seen in keratoconus (keratometric myopia). 10,11 There is no clinical basis for the choice of an AL greater than 30.0 mm as a definition of extreme myopia.…”

Retinal detachment after phacoemulsification in high myopia: Analysis of 2356 cases

“…[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][35][36][37][38][39][40][41][42] This reflects the varying definitions of myopia, inclusion and exclusion criteria, length of follow-up, and different cataract extraction surgical techniques. In light of the progress in surgical technique, several studies of RD after cataract extraction in highly myopic eyes have lost relevance.…”

“…In light of the progress in surgical technique, several studies of RD after cataract extraction in highly myopic eyes have lost relevance. [35][36][37][38][39][40][41][42] Table 4 shows the results in studies in which most patients had phacoemulsification with in-the-bag IOL fixation. According to these studies, the RD rates after modern cataract surgery or RLE are comparable to those in the present study.…”

“…This may be because until a few years ago, PC IOL implantation was not routinely performed in highly myopic patients as the IOL dioptric power was not available or the surgeon wanted to preserve retinal visibility in case of subsequent retinal surgery. 21,36 There seems to be evidence, however, that the rate of retinal complication is the lowest after posterior chamber IOL implantation, 28,42,48 which is why our study included only eyes with planned PC IOL implantation in the capsular bag. Furthermore, in Ripandelli et al's study, 26 more than 50% of the RDs were posterior detachments limited to the posterior pole, which do not characteristically occur in relation to pseudophakia, as discussed above.…”

The Analysis of Refraction and Accommodation of Extreme Myopia with Cataract after Phacoemulsification and IOL Implantation

“…Lee at 6 suggested that a definition of high myopia based on axial length is more appropriate than that based on refraction; however, nuclear cataract usually causes a myopic shift in refraction. 7 In this study, an axial length of ≥27mm and refraction of ≥-10D were chosen for the inclusion criteria because we believe that this is a better estimation for extreme myopia.…”