Firstly, we would like to clarify that there is currently no surgical treatment that can stop the advancement of myopia (short-sightedness). Therefore, the treatment aims to correct the refractive error, that is to say, the number of dioptres the patient has, once it is stable, and thus reduce or, in many cases, avoid dependence on glasses. 

There are also surgical techniques that prevent or treat the complications of myopia magna, such as retinal tears, neovascular membrances, cataracts or retinal detachment. 

In terms of refractive error treatment, that is to say, the elimination of dioptres, surgery will greatly depend on the degree of myopia and the characteristics of the cornea.

Simple myopia, (less than 6 or 7 dioptres) can usually be treated with laser surgery which modifies the surface of the cornea in a very simple way. 

With higher degrees of myopia, the changes caused by the laser might put the structural integrity of the cornea at risk because of the high number of dioptres to eliminate. For this reason, after an exhaustive feasibility study, we should opt for other surgical techniques that do not change the corneal structure. 

These techniques involve intraocular lens implants. 

There are basically two types of intraocular lenses: 

• Phakic or ICL lenses: These lenses are similar to contact lenses. They are smaller in size and they are placed on the inside of the eye on the surface of the crystalline lens, behind the pupil, instead of on the cornea like the conventional contact lenses that we all know.
• Lenses that substitute the crystalline lens: These lenses are a similar size to those above and are put in place of the crystalline lens, that is to say, they replace them. The surgical technique used to implant these lenses is the same as the technique used in cataract surgery. For this reason, they are implanted in older patients whenever they have cataracts or are close to having them. 

On the other hand, as mentioned before, there are surgical techniques that do not aim to correct the dioptres but rather treat the possible complications of myopia magna, such as: 

• Laser photocoagulation in the case of retina tears. 
• Intravitreal injections in the case of neovascular membrane haemorrhages. 
• Vitrectomy in the case of haemorrhages, retinal detachment or macula problems. 

As intraocular implant surgery does not stop the advancement of myopia, it must be performed when the myopia is stable, that is to say, when we think that it will not increase significantly. For this reason, where high myopia with a more prolonged development is concerned, it is usually performed over the age of 25, provided no changes in the prescription have been detected in the preious year. 

Does this mean that your myopia will definitely not increase after the operation? The answer is no, but the likelihood that it continues to advance is much lower than in younger people who get the same operation.

Phakic or ICL lenses are normally implanted under the age of 40 given that it is important to respect the role of a crystalline lens which works properly until this age. 

From the age of 50, the crystalline lens is not able to focus on nearby objects like it used to. For this reason, an ICL implant does not make much sense and it would be more appropriate to extract the crystalline lens and implant a lens to substitute it, with the additional advantage that if we implant a multifocal intraocular lens, we can also correct presbyopia, which also exists at this age.