Five Pearls for Long Eyes

L ong eyes present unique challenges during cataract surgery.We provide five pearls for optimizing cataract surgery for these patients.The first is a complete preoperative examination, particularly looking for risk factors for retina complication following surgery.The second is to the refractive target with the patient, especially as many are near-sighted and may not understand that giving up near vision is the side effect of aiming for emmetropia with a monofocal lens.The third is to carefully evaluate of the biometry data and formulas available in these eyes, which can have unusual refractive results.Fourth is to plan for intraoperative surprises, including reverse pupillary block, deep anterior chamber and possible weak zonules that may require sizing of lenses and capsule tension rings for larger eyes.Finally, the fifth is to have a plan for the anisometropia between eyes.With these tips and careful counselling, patients can have excellent results after cataract surgery, despite having larger eyes.