Secondary cataracts in extreme myopia

INTRODUCTION: After cataract surgery there is a higher incidence of posterior capsular opacification (secondary cataract) in myopia than in normal population, and it varies from 40 to 60% 1, 2]. METHODS: Fifty myopic eyes operated for cataract at Prof. Dr. Ivan Stankovitsh Eye Department from 1988 to 1995 were examined for capsular opacification (secondary cataract). Extracapsular cataract extraction was performed in all patients and in 32 patients the posterior intraocular lens was placed. Capsular opacification was classified by type and treated with Nd:YAG laser or discussion at least 9 months to 3 years and 3 months from the operation. RESULTS: There were 13 secondary cataracts (26%) in our series of patients, of whom 22% with intraocular lenses, and 33% were aphakic patients. Visual acuity was 4/60 to 0.5. In 11 patients YAG-laser capsulotomy was performed and in one patient capsular discussion, and in one subject there was no treatment. Consequent visual acuity was 0.3 to 1.0. No correlation was found between the age, type of intraocular lens and capsular opacification. DISCUSSION: Capsular opacification is more often seen in myopic eyes and its treatment is associated with a higher rate of complications (cystoid macular oedema, rupture of anterior hyaloid, retinal detachment...) 3, 4]. It seems that posterior lens implants reduce the chance for development of posterior capsular opacification. The safest treatment is YAG-laser capsulotomy.