Cataract surgery is a standard procedure for restoring vision for people with cloudy lenses. The surgery can improve a person’s visual acuity, but patients with high myopia should be cautious because of safety concerns.
These patients face an increased chance of developing complications because of thinning of the retina, which can occur during cataract surgery. They may experience more difficulty achieving 20/20 vision following the procedure and higher incidence rates of corneal edema (swelling) and inflammation.
For individuals over 50, pre-existing age-related macular degeneration (AMD) poses additional risks during and after cataract surgery.
How Does Myopia Affect Cataract Development?
Cataracts are a natural result of aging because of a protein buildup on the eye’s lens. Studies have identified high myopia as a significant factor in the increase in cataract development.
To understand the potential complications better, one needs to understand the different classifications of cataracts.
Professionals have classified cataracts into three main types based on their location in the eye.
- Nuclear cataract forms in the center of the lens.
- A cortical cataract starts at the edges of the lens and progresses toward the center in a wedge shape.
- Posterior capsular cataract forms behind the lens, obstructing the passage of light to the retina.
Overview Of Cataract Surgery
During cataract surgery, the surgeon removes the clouded lens from the eye and replaces it with an artificial lens. They perform the procedure under local anesthesia, typically lasting about 30 minutes.
Surgeons achieve successful outcomes in over 95% of cataract surgery cases. Patients can resume regular activities within a few days, as the procedure is outpatient. However, only 63% of patients with myopia and an axial length exceeding 26 mm attain a visual acuity of at least 20/40 after cataract surgery because of ocular comorbidities.
Risk Factors Causes by High Myopia In Surgical Patients
Studies show that patients with high myopia may have a higher risk of experiencing posterior capsule rupture, retinal detachment, and macular edema. The surgical procedure can worsen pre-existing conditions like glaucoma or macular degeneration.
Despite these risks, surgical techniques and technology advancements have improved cataract surgery’s safety and efficacy. Most patients with high myopia can undergo the procedure successfully.
The primary complications that may arise during cataract surgery are:
Although rare, there is a minor risk of eye infection (1 in 1000) post-surgery. Various factors could cause this, such as unsterilized equipment, microbial contamination, or a weakened immune system. Preoperative antibiotics can help minimize this risk. Your ophthalmologist can guide you on maintaining optimal eye health and overall well-being following the procedure.
Excessive bleeding during surgery is a rare complication but can occur in patients with uncontrolled high blood pressure or those taking blood-thinning medications. It would be best to inform your doctor of medicines to avoid this risk.
Posterior Capsular Rupture:
Posterior capsule rupture is a rare complication when a tear or break in the bag holds the lens during cataract surgery. Which can prolong the surgical procedure, increase the surgery cost, and delay visual recovery. The severity of the tear determines whether the surgeon can manage it independently or call in a retinal specialist for their expertise.
Retinal tears or detachment:
Patients with pre-existing eye conditions, such as myopia or diabetes, may have a higher risk of experiencing these complications. A specialist can manage a retinal tear or detachment through surgical or non-surgical treatments if they detect it early. However, if left untreated, it can lead to permanent vision loss.
Surgery is the primary method for removing and replacing a damaged lens. However, high myopia may pose potential complications during surgery, such as retinal detachment or an unpredictable postoperative refractive error, leading to nearsightedness. A follow-up operation may be necessary to address these issues.
Any patient considering cataract surgery must understand all potential risks associated with their condition. Discuss your situation with an eye care professional. This will enable you to ensure that cataract surgery is safe for you.