Intraocular lens implantation and high myopia.

We evaluated aphakia and pseudophakia in highly myopic patients whose axial lengths were 27 mm and over. Cataract surgery alone was performed on 99 eyes (aphakic group) and intraocular lens (IOL) implantation was performed on 84 eyes (pseudophakic group). The IOL power was determined by the SRK formula and ranged from +9.0 to +18.5 diopters (D). There was no statistical difference in postoperative complications between the aphakic and pseudophakic groups. The postoperative aphakic refractions ranged from +9.5 D to -3.5 D, and the pseudophakic refractions, from +2.5 D to -14.0 D. A visual acuity of 20/40 or better was achieved by 51% of aphakic patients and 63% of pseudophakic patients. A near visual acuity of 20/40 or better was achieved by 65% of pseudophakic patients. Seventy-three pseudophakic eyes (87%) were not corrected or were corrected with minus diopter lenses. This confirmed our opinion that there was no need to correct them for near vision. According to a postoperative questionnaire, 67% of the pseudophakic patients did not need spectacles for near vision and 93% of patients could see comfortably for daily life. In view of these results, we feel that most myopic patients are good candidates for IOL implantation.