Cataract surgery in patients with chronic severe graft-versus-host disease

Abstract

To evaluate the surgical outcomes of cataract extraction with phacoemulsification and intraocular lens implantation in patients with severe chronic ocular graft-versus-host disease (GVHD). University of South Florida Eye Institute, Tampa, Florida, USA. Retrospective case study. A chart review was performed to identify patients with clinically severe, biopsy-proven chronic ocular GVHD who had cataract extraction. Outcome parameters included preoperative andpostoperative corrected distance visual acuity (CDVA), type of cataract, postoperative complications, type of underlying malignancy, and time from bone marrow transplant to cataract extraction. This study comprised 10 eyes of 6 patients with severe GVHD. Posterior subcapsular cataract accounted for all cataracts that were surgically removed in this patient cohort. The mean preoperative CDVA was 20/84, which improved to 20/30 at the 1-month postoperative visit and remained stable at 20/28 at the final visit noted in the charts (both P<.05). Two patients developed postoperative corneal melting. All but 1 patient had improved visual acuity after surgery. With meticulous preoperative biometric measurements and calculations and aggressive assessment and treatment of dry-eye syndrome, patients with severe ocular GVHD who had cataract extraction had excellent postsurgical refractive outcomes. Postoperative corneal melting was a complication seen with greater frequency than anticipated in this patient cohort. None of the authors has a financial or proprietary interest in any material or method mentioned.