Gülşah Gümüş Akgün, Neşe Alagöz, Ece Doğruel, Nilay Kandemir Beşek, Ahmet Kırgız, Erdem Erdoğdu, İhsan Çakır, Çiğdem Altan, Tekin Yaşar
Türk Oftalmoloji Dergisi - 2025;55(6):336-340
Objectives: To evaluate the refractive outcomes, changes in intraocular pressure (IOP) and anterior chamber depth (ACD), and postoperative complications following lensectomy for angle-closure in cases of simple extreme microphthalmos. Materials and Methods: This retrospective study analyzed eyes with simple extreme microphthalmos (axial length <18 mm) that underwent lensectomy between January 2015 and July 2024. Data collection included demographic details, preoperative and postoperative best corrected visual acuity (BCV A), IOP , number of antiglaucoma medications, ACD, the diopter (D) of the implanted intraocular lens (IOL) according to the Hoffer-Q formula, postoperative refractive error, and surgical complications. Results: A total of 20 eyes from 12 patients were analyzed, with a mean patient age of 55.4+/-8.7 years and an average axial length of 16.48+/-0.8 mm. The average power of the implanted IOL was 53.32+/-6.2 D, ranging from 44 to 64 D. The mean preoperative spherical refractive equivalent (SE) was +12.4+/-2.8 D, while the mean postoperative SE was -6.67+/-5.2 D (p<0.05). Postoperative spherical refractive error exceeding -1.00 D was detected in 15 eyes (75%). Postoperatively, significant decreases were observed in IOP and the need for antiglaucoma medication (p=0.02 for both). The mean ACD increased significantly after surgery compared to the preoperative ACD (p=0.01). The difference between the intended refractive outcome and the postoperative spherical refractive error was statistically significant (p<0.05). Postoperatively, 8 eyes (40%) had a BCV A of <=0.7 logarithm of the minimum angle of resolution (logMAR), 10 (50%) had a BCV A between >0.7 and <1.4 logMAR and 2 eyes (10%) had a BCV A of >=1.4 logMAR. Conclusion: Lensectomy in cases of extreme microphthalmos effectively reduces IOP and reliance on antiglaucoma medications and increases the ACD. However, a notable incidence of postoperative myopic refractive error remains a concern.
