| The patients with high myopia and cataract were considered to have great danger to be performed operation , because of their long axis oculi,thin sclera,fluid opacitas vitreous,degeneration of the macular area and peripheral retina. With the development of modern extracapsular extraction (ECCE) and phacoemulsification (PHACO), more and more these patients can see the bright light again .in order to approach the curative effect of the two operations,53 cases(68 eyes) who visited our hospital between 2004.7 and 2006.7 were collected.During the operation 47 eyes were implanted intraocular lens(IOL),the other 21 eyes were not implanted IOL because of below reasons,including big posterior capsular rupture and dimensionality of IOL calculated by the formula close to 0D.the dimensionalit of the implanted IOL were between +2D and +16D,among them the folding IOL were 3 pieces. PHACO group:36 eyes,29 eyes of the total were implanted IOL,among them whose axis oculi between 26mm and 29mm were 17 eyes,≥29mm were 12 eyes.ECCE group: 32eyes,20 eyes of the total were implanted IOL,among them whose axis oculi between 26mm and 29mm were 15 eyes,≥29mm were 5 eyes.After the operations we found:1.best corrected visual acuity(≥0.3 was the standard),①PHACO group with implantation of IOL was 58.62%(17/29), ECCE group with implantation of IOL was 60%(12/20),P>0.05,the difference had no statistical significance.②best corrected visual acuity≥0.3 of the eyes with implantation of the IOL was 59.2%(29/49),it was 31.2%(6/19)for the aphakic eyes, P<0.01, the difference had statistical significance.③best corrected visual acuity≥0.3 of the eyes whose axis oculi between 26mm and 29mm was 67.5%(27/40),≥29mm was 28.6%(8/28),P<0.01, the difference had statistical significance. 2.Complication of midstoperation: posterior capsular rupture was 10.3%(7/68) . among them the PHACO group were 3 eyes, among them the crack of 1 eyes was 1mm,vitreous which escaped to the anterior chamber were cutted off and one IOL was implanted; the other 2 eyes were not implanted IOL bacause of big crack; there were 4 eyes in ECCE group,they were not implanted IOL bacsuse of big crack.3.Complication of postoperation : inflammatory reaction of anterior chamber,corneal edema,anterior chamber hyphema,heightened intraocular tension,corneal edema were 9 eyes ( 13.2% , 9/68 ),40 eyes had different degree inflammatory reaction of anterior chamber,aqueous fluid flash( +-+++ ) ,3 eyes had cellulose effusion,they were given cidomycin and decaesadril sub-conjunctival injection,above reactions disappeared between 3 and 7 days; 2 eyes had different degree corneal edema,anterior chamber hyphema,heightened intraocular tension,they were given acetazolamide and adrenobazone by mouth,Reptilase and endoiodin by muscle injection, anterior chamber hyphema disappear within 7 days,and the cornea was transparent,intraocular tension also became nomal.The possible reasons of the midstoperational complication:posterior capsular rupture①use justo major strength to cut off the crystal nucleus, the crystal nucleus was erect in the sac to oppress the post-peplos.②the crystal nucleus rolled in the sac during the emulsification,the keen verge lacerated the post-peplos.③pressed the post-peplos excessively when taking out of the crystal nucleus. During the follow-up, we found no after-cataract, retinal detachment and cystoid macular edema. (1)after-cataract was related to inflammatory teaction and endothelial cell multiplication,the former was the result of surgical trauma and reliquus tissue fragment,the latter had association with too much reliquus endothelial cell of the crystalline lens.(2)detachment of retina: posterior capsular rupture during the operation can make antedisplacement of the vitreous,thereby the strength vitreous drag the retina was increased. (3)cystoid macular edema is the result of increased permeability of the macula lutea micrangium.We make conclusion that: 1.PHACO+IOL and ECCE+IOL are both modus operandi for the cataract with high myopia. 2.The patients of high myopia with cataract should implant the IOL during the operation as far as possible,in order to get better vision. 3.The best corrected visual acuity was not ideal for the patients whose axis Oculi≥29mm.
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