These are some of the most rewarding cataract surgeries to perform since we can correct the cataract as well as the extreme myopia at the same time. These patients are often -15 diopters, -20 diopters, or even more myopic and while they often wish for perfect distance vision, we must be careful to land on the side of mild myopia instead of mild hyperopia. The surgery itself is also more challenging because of issues such as reverse pupillary block (also called LIDRS: lens iris diaphragm retropulsion syndrome). In addition, barotrauma from changes in pressure may put stress on the vitreous base and therefore traction on the retina. These patients should have their retinas checked thoroughly before cataract surgery and then again in the post-operative period.
The patient had a beautiful result which you can see in this picture. We used a very low power IOL which was available only in the meniscus design. If you don’t know what that means, then you should do some more reading here.
click to watch the video and learn from this complete cataract case: