Ke-Bing Zhao,1,2 Jing-Shang Zhang,2 Xiu-Hua Wan2 

1School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, 261000, People’s Republic of China; 2Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, People’s Republic of China

Correspondence: Xiu-Hua Wan, Email xiuhuawan@126.com

Purpose: To evaluate the visual outcomes and complication rates of cataract surgery in high myopic patients through a systematic review and meta-analysis.
Methods: Following the PRISMA 2020 guidelines, a comprehensive literature search was conducted across multiple databases to identify studies reporting on cataract surgery outcomes in highly myopic patients. Eight studies, involving 1,996 patients (2,826 eyes), were included in the meta-analysis. Data on pre- and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and study characteristics were extracted. Random-effects models were used to calculate pooled estimates due to significant heterogeneity among studies.
Results: Cataract surgery significantly improved BCVA in high myopic patients, with an average improvement of − 1.72 logMAR units (95% CI: − 2.37 to − 1.06). Substantial heterogeneity was observed across studies (I² = 84.4%, 95% CI: 65.2%– 93.1%). Intraoperative and postoperative complications occurred at the following pooled incidences: transient intraocular pressure (IOP) elevation 13.03% (95% CI, 9.59%– 17.47%), posterior capsule opacification (PCO) at 12.11% (95% CI, 4.00%– 31.30%), cystoid macular edema (CME) at 2.41% (95% CI, 0.84%– 6.76%), intraoperative posterior capsule rupture (PCR) at 2.01% (95% CI, 0.89%– 4.44%), retinal detachment (RD) at 1.97% (95% CI, 1.21%– 3.21%), retinal breaks at 1.89% (95% CI, 0.85%– 4.14%) and intraocular lens (IOL) dislocation at 0.67% (95% CI, 0.21%– 2.04%).
Conclusion: Cataract surgery is effective in improving vision in highly myopic patients but is associated with a moderate risk of complications. The high heterogeneity among studies underscores the need for standardized methodologies and more comprehensive assessments of ocular health in future research. These findings provide valuable insights for optimizing clinical management and enhancing patient counseling.

Keywords: high myopia, cataract surgery, visual outcomes, complications, meta-analysis