Capsular adhesion to intraocular lens in highly myopic eyes evaluated in vivo using ultralong-scan-depth optical coherence tomography.

Purpose: To evaluate the in vivo capsular apposition to the intraocular lens (IOL) in subjects with high myopia by ultralong-scan-depth optical coherence tomography (OCT).

Design: Prospective observational case series.

Methods: Forty eyes from 40 cataract patients scheduled for phacoemulsification surgery at the Affiliated Eye Hospital, Wenzhou Medical College were studied, of which 20 eyes were highly myopic (axial length >26 mm) and 20 eyes were emmetropic (22 mm < axial length <24.5 mm). All eyes were examined with a custom-built ultralong-scan-depth OCT at 4 hours, 1 day, 7 days, 14 days, and 28 days after surgery.

Results: Anterior capsule contact with the IOL was significantly delayed in highly myopic eyes. Complete apposition of the posterior capsule with the IOL was significantly less common among highly myopic eyes than in emmetropic eyes (4 vs 16 eyes; P = .001). Posterior capsule adhesion to the IOL was inversely correlated with axial length (r = -0.494, P < .001, nonparametric Spearman test). The 3 types of complete adhesive capsular bend configurations observed were classified as anterior adhesion, middle adhesion, and posterior adhesion. Incomplete adhesion patterns were classified as funnel adhesion, parallel adhesion, and furcate adhesion. Five highly myopic eyes had slight posterior capsule opacification (PCO) at the last follow-up, as did 1 emmetropic eye.

Conclusions: Ultralong-scan-depth OCT revealed weak capsular adhesion and incompletely adhesive types of capsular bend in highly myopic eyes. These features presumably increase the likelihood of PCO during the early postoperative period.