Difference between revisions of "High Myopia and Cataract Surgery"

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Myopia is highly prevalent in the general population, affecting approximately 25%. It affects a larger proportion of Asians and a smaller proportion of African Americans. High myopia affects about 2% of the population. ''High myopia'' refers to a spherical equivalent of -6.00 D or less or an axial length of 26.5 mm or more. ''Pathologic myopia'' refers to a spherical equivalent of -8.00 or less or an axial length of 32.5 mm or more.<ref name="BCSC Retina">Basic Clinical and Science Course. Retina and Vitreous. 2013-14. Section 12 pg 85-86.</ref><br>  
 
Myopia is highly prevalent in the general population, affecting approximately 25%. It affects a larger proportion of Asians and a smaller proportion of African Americans. High myopia affects about 2% of the population. ''High myopia'' refers to a spherical equivalent of -6.00 D or less or an axial length of 26.5 mm or more. ''Pathologic myopia'' refers to a spherical equivalent of -8.00 or less or an axial length of 32.5 mm or more.<ref name="BCSC Retina">Basic Clinical and Science Course. Retina and Vitreous. 2013-14. Section 12 pg 85-86.</ref><br>  
  
According the the Beaver Dam Eye Study and the Blue Mountains Eye Study, there is an association between myopia and nuclear cataract. The Blue Mountains Eye Study also found that moderate and high myopia, especially with onset prior to age 20, are associated with posterior subcapsular cataract formation.<ref name="Dodick">Dodick, JM, Kahn JB. Special Considerations for Cataract Surgery in the Face of Pathologic Myopia. In: Spaide, RF, Ohno-Matsui, K, Yannuzzi, LA, eds. Pathologic Myopia. New York, NY: Springer Science+Business Media; 2014:313-314.</ref>
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According the the Beaver Dam Eye Study and the Blue Mountains Eye Study, there is an association between myopia and nuclear cataract. The Blue Mountains Eye Study also found that moderate and high myopia, especially with onset prior to age 20, are associated with posterior subcapsular cataract formation.<ref name="Dodick">Dodick, JM, Kahn JB. Special Considerations for Cataract Surgery in the Face of Pathologic Myopia. In: Spaide, RF, Ohno-Matsui, K, Yannuzzi, LA, eds. Pathologic Myopia. New York, NY: Springer Science+Business Media; 2014:313-314.</ref>  
  
= Preoperative Evaluation =
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= Preoperative Evaluation<br> =
 
 
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== Patient Expectations  ==
 
== Patient Expectations  ==
  
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It is important to have a thorough discussion with the highly myopic patient about setting realistic goals and expectations regarding cataract surgery outcomes. If corrected for distance, patients should be advised that they will experience more difficulty with near vision. Some may opt for monovision in order to maintain the ability to see up close.&nbsp;
  
 
== Risks and Informed Consent  ==
 
== Risks and Informed Consent  ==

Revision as of 12:58, September 28, 2014

Article summary goes here.

Epidemiology

Myopia is highly prevalent in the general population, affecting approximately 25%. It affects a larger proportion of Asians and a smaller proportion of African Americans. High myopia affects about 2% of the population. High myopia refers to a spherical equivalent of -6.00 D or less or an axial length of 26.5 mm or more. Pathologic myopia refers to a spherical equivalent of -8.00 or less or an axial length of 32.5 mm or more.[1]

According the the Beaver Dam Eye Study and the Blue Mountains Eye Study, there is an association between myopia and nuclear cataract. The Blue Mountains Eye Study also found that moderate and high myopia, especially with onset prior to age 20, are associated with posterior subcapsular cataract formation.[2]

Preoperative Evaluation

Patient Expectations

It is important to have a thorough discussion with the highly myopic patient about setting realistic goals and expectations regarding cataract surgery outcomes. If corrected for distance, patients should be advised that they will experience more difficulty with near vision. Some may opt for monovision in order to maintain the ability to see up close. 

Risks and Informed Consent

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IOL Calculations

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IOL Selection

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Perioperative Period

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Anesthesia

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Intraoperative Complications

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Surgical Technique

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Postoperative Management

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Medications

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Follow Up

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Late Complications

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Additional Resources

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References

  1. Basic Clinical and Science Course. Retina and Vitreous. 2013-14. Section 12 pg 85-86.
  2. Dodick, JM, Kahn JB. Special Considerations for Cataract Surgery in the Face of Pathologic Myopia. In: Spaide, RF, Ohno-Matsui, K, Yannuzzi, LA, eds. Pathologic Myopia. New York, NY: Springer Science+Business Media; 2014:313-314.


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