Navigating Retinal Complications and Refractive Outcomes in High Myopia: A Case Report With Multi-surgical Interventions

Refraction through the ocular system is the process of bending light rays within the eye's optical system, which includes the cornea, anterior chamber, lens, and vitreous body. These structures work together to ensure precise focusing of light on the retina, enabling clear vision. Dysfunction or pathology at any level of the optical system can significantly affect the quality of vision, leading to changes in refractive status and visual acuity disturbances. A 58-year-old female patient presented to the Ophthalmology Clinic for a follow-up evaluation of her visual system after multiple previous surgeries, including radial keratotomy, multiple pars plana vitrectomies (PPV) due to recurrent retinal detachments, cataract phacoemulsification with intraocular lens implantation, and bilateral YAG-capsulotomy. Visual acuity was 0.004 in the right eye (OD) and 0.01 in the left eye (OS), with intraocular pressure of 20 mmHg in the OD and 18 mmHg in the OS. Autorefractor measurements were OD: +1.25/-4.0 ax 110° and OS: +1.25/-4.75 ax 130°. Pachymetry showed a central corneal thickness of 532μm in the OD and 518μm in the OS. Refraction measured by the WASCA (Wavefront Aberration Supported Cornea Ablation; (Carl Zeiss Meditec, Oberkochen, Germany)) wavefront aberrometer was +5.36/-2.43 ax 129° in the OD and +1.34/-4.08 ax 110° in the OS. Biometry results were 31.02 mm for the OD and 31.87 mm for the OS. High myopia presents complications that contemporary ophthalmology is capable of managing, even in its most severe stages. Advances in modern treatment methods often enable specialists to maintain functional visual acuity, ensuring patients can achieve a meaningful level of vision despite the challenges posed by advanced myopic conditions.