AIM: To explore the effect of phacoemulsification and intraocular lens implantation in the treatment of patients with high myopia complicated with cataract.

METHODS: A retrospective study was conducted. A total of 42 cataract patients(42 eyes)with high myopia who had undergone phacoemulsification combined with intraocular lens implantation from February 2017 to January 2019 were recruited as myopia group. Meanwhile,in a 1:1 ratio, 42 cataract patients(42 eyes)without myopia treated with phacoemulsification combined with intraocular lens implantation during the same period were selected as the control group. The best corrected visual acuity(BCVA)of both groups was measured before surgery and at 1wk, 1 and 3mo after surgery. Changes of intraocular pressure(IOP)and central macular thickness(CMT)were measured before surgery and at 3mo after surgery. Changes of anterior segment parameters such as corneal curvature, corneal astigmatism, anterior chamber depth, anterior chamber angle and angle open distance before surgery and at 3mo after surgery were recorded. Changes of corneal endothelial cell counts and hexagonal cell ratios in both groups before surgery and at 3mo after surgery were determined. The incidence of surgical complications in the two groups were statistically analyzed.

RESULTS: There were differences in postoperative BCVA of patients in the two groups at 1wk, 1 and 3mo after surgery(all P<0.001); The CMT, anterior chamber depth, angle open distance and anterior chamber angle of myopia group were larger than those of the control group before surgery and at 3mo after surgery(P<0.001), but there was no statistically significant difference in IOP between the two groups before and after surgery(P>0.05). The posterior supra-nasal corneal curvature of the myopia group at 3mo after surgery was larger than that before surgery(P<0.001), and the posterior center, corneal curvature under the temporal of the control group at 3mo after surgery was larger than that before surgery(P<0.001). The corneal curvature of posterior center and posterior infratemporal in myopia group was lower than that of the control group at 3mo after surgery(all P<0.05). The anterior and posterior corneal astigmatism of the two groups increased at 3mo after surgery(all P<0.001), and posterior retrograde astigmatism of both groups increased at 3mo after surgery(P<0.05), but there was no statistically significant difference between groups(P>0.05). The corneal endothelial cell counts and hexagonal cell ratios in both groups at 3mo after surgery were lower than those in the same group before surgery(P<0.05). Besides, the corneal endothelial cell counts and hexagonal cell ratio in myopia group were lower than those in the control group at 3mo after surgery(all P<0.05); The incidence of surgical complications in the myopia group was higher than that in the control group, but there was no statistical difference between the groups(P>0.05).

CONCLUSION: Phacoemulsification combined with intraocular lens implantation is beneficial to the visual acuity of patients with high myopia complicated with cataract, but the effect is not as good as that in patients with cataract alone. The postoperative CMT of patients with high myopia complicated with cataract is larger than that of patients without myopia, and there is an increase in the posterior astigmatism. The changes of anterior chamber morphology are more obvious, and corneal endothelial cells aremore severely damaged, but it is relatively safe and reliable.