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    Nearsightedness can increase risk of developing cataract complications

    By Emily Hagan | Published on Oct 17, 2023

    Nearsightedness, commonly known as myopia, is a condition that impairs distant vision without the aid of glasses. It predominantly affects school-going children and, according to a study conducted by the All India Institute of Medical Sciences (AIIMS), 1 out of every 6 children aged 5-15 in India suffers from myopia. Recent studies have found a concerning link between nearsightedness and the development of cataract complications.

    Causes of Cataract

    While the exact cause is yet unclear, research suggests that the elongation of the eyeball, which occurs in myopic eyes, can hinder the delivery of essential nutrients to the backside of the lenses. Consequently, individuals may experience a loss of visual clarity and the formation of cataracts. Though surgical intervention is an effective method to address cataracts, it becomes more challenging for those with high myopia.

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    Risks of Cataract Surgery in High Myopia Patients

    Patients with high myopia face increased risks during cataract surgery due to the following reasons:

    1. Complicated Surgery

    The surgical removal of cataracts becomes increasingly complex and risky in cases of high myopia. The overstretched eyeball presents difficulties in accurately determining the power of the replacement lens, potentially leading to less reliable outcomes and reducing the overall success rate of the procedure. Additionally, various eye conditions may arise during the surgery.

    2. Retinal Detachment

    The shape of highly myopic eyes makes individuals more susceptible to retinal detachment, both during and after cataract surgery. Without proper precautions, this can significantly increase the risk of vision loss.

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    How to Mitigate the Risk of Cataract Complications

    Given the heightened risk of complications in high myopia patients, surgeons must thoroughly assess the benefits and risks associated with surgery. Compared to eyes without refractive errors, myopic eyes carry a greater risk of retinal complications, such as retinal detachment. It is critical for surgeons to identify any retina breaks, weaknesses, or holes.

    Furthermore, individuals with high myopia may experience additional conditions, such as epiretinal membranes, macular degeneration, or other significant changes, which can limit the vision achieved through surgery and influence postoperative complications like cystoid macular edema. Accurate assessment of the retinal status and measurement of the eye’s axial length are crucial in avoiding potential issues. High nearsightedness can result in a posterior staphyloma, commonly observed in highly myopic patients with long axial lengths. Using an optical method for measurement is highly recommended due to its superior accuracy, as standard A-scan ultrasounds may produce erroneous results.

    Conclusion

    While cataract surgery remains an effective solution for treating cataracts, patients with high myopia require extra precautions and postoperative follow-ups due to their increased risk of intraoperative and postoperative complications. Surgeons must carefully consider the individual circumstances and ensure that proper measures are in place to minimize any adverse effects. By addressing these concerns, patients can undergo cataract surgery with confidence and achieve the best possible outcomes.

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