Role of anterior chamber maintainer in preventing pseudophakic retinal detachment in highly myopic eyes

Purpose To investigate the effect of anterior chamber maintainer (ACM) usage during phacoemulsification on the occurrence of pseudophakic retinal detachment (PRD) in high myopia. Design A retrospective nonrandomized comparative interventional study was conducted. Participants A total of 632 high myopic eyes of 501 patients who had eventless phacoemulsification with in-the-bag intraocular lens implantation in the period between March 2013 and December 2018. Methods Patients were divided into two groups according to the use of ACM during cataract surgery: (a) ACM group, and (b) no-ACM group. Patients were followed at 6, 12, 18, 24, 30, and 36 months after surgery for detection of PRD. The time-related cumulative incidence of RD in each group was evaluated by means of Kaplan–Meier survival curves. Results In the ACM group, the 3-year cumulative incidence of RD was 2.4% compared with 5.9% in the other group (P=0.039). Regarding age, the 3-year cumulative incidence of RD increased significantly in the younger age group when the ACM was not used (P=0.023), whereas it was not when the ACM was used. Using the ACM increased the 3-year cumulative survival ratio from 86.2 to 92% in patients with a posterior staphyloma (P=0.03). Conclusion ACM is a potential prophylactic intraoperative tool against PRD in highly myopic eyes.