Retinal detachment as a potential hazard in surgical correction of severe myopia with phakic anterior chamber lenses.

Phakic anterior chamber lenses have been proposed as an effective refractive surgical procedure for the correction of severe myopias. We managed three cases of retinal detachment that complicated this operation. Two patients had retinal detachment in the immediate postoperative period at the fourth and sixth weeks, respectively. Both patients had preoperative equatorial lattice degeneration, which was prophylactically managed with argon laser in one case. The third patient developed retinal detachment at the eighth postoperative month and was associated with a severe fibrinoid uveitis and a combined exudative and rhegmatogenous retinal detachment. This third patient did not have any previous retinal degenerative lesion. Scleral buckling was successful in two of the patients, whereas the patient with preoperative inflammation required vitreous surgery because of proliferative vitreoretinopathy. The retinas were reattached in all three patients without explanting the phakic anterior chamber lens, but severe loss of visual acuity occurred in one patient. Retinal detachment should be regarded as a potentially important hazard in this type of refractive surgery.