Phaco-refractive surgery in eyes with simple microphthalmia
Keywords:
axial hypermetropia, microphthalmos; phaco-refractive surgery; phacoemulsification, axial hypermetropia, microphthalmos, phacoemulsificationAbstract
Introduction: the intensive technological advance of last years has brought the development of the phaco-refractive surgery, which can achieve the potential improvement from the functional and refractive point of view of the eyes with simple microphthalmos. To minimize the risks of complications and to improve the quality of the refractive results, there is necessary the adoption of measures prophylactic and taken care in the preoperative, intraoperative and postoperative.
Objective: To evaluate the results of the phaco-refractive treatment in patients with simple microphthalmos.
Method: Descriptive, prospective study in 36 eyes with simple microphthalmos operated by phacoemulsification and intraocular lens implant from May 2014 to 2016. We analyzed the visual and refractive recovery, the predictability of intraocular lens calculation (between two formulas: Hoffer Q and Haigis), and the occurrence of intraoperative and postoperative complications. Follow-up was performed for 3 months.
Results: Most patients were females (78.8%), aged over 40 years (n=17.94%), and eyes with axial length less than 21 mm (35 eyes, 97%) and high hypermetropia, greater than 3 diopters 80.6%). The visual acuity without correction improved from 0.1 in the preoperative to 0.8, with 11 (35.4%) eyes that obtained maximum vision after 3 months. The obtained sphere tended to slight hypermetropia + 0.09D (DS ± 0.62). 45% (16 eyes) remained without refractive defect, 92% (33 eyes) remained with a sphere between ± 1.00D and, out of the 3 eyes (8%) that were outside the desired range, 2 were calculated by Hoffer Q. There was no case in which the sphere exceeded 2 diopters. Intraoperative floppy iris syndrome (IFIS) in 8 eyes (22%) was the most common intraoperative complication. Corneal edema and mild anterior uveitis were frequent between 24 hours and one week and all cases were given a solution.
Conclusions: Phaco-refractive surgery in microphthalmos and high axial hypermetropia is an excellent alternative for its refractive correction.
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