Outcomes of phacoemulsification in patients with chronic ocular graft-versus-host disease
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The purpose of this study was to evaluate the outcomes of phacoemulsification in patients with ocular graft-versus-host disease (GVHD).
The occurrence of cataracts, cataract surgery, and its outcomes were analyzed in the medical records of 229 patients (458 eyes) with ocular GVHD. Outcome measures included pre- and postoperative corrected distance visual acuity (CDVA) and the rate of postoperative complications.
Of the 458 eyes evaluated, 58 were pseudophakic; from the 400 phakic eyes, 238 (59 %) presented with cataracts and 62 (26 %) underwent cataract surgery. Analysis of postoperative complications and visual outcomes at 1 month was performed in 51 eyes in which detailed surgical and immediate postoperative records were available. Preoperatively, the mean CDVA was 0.67 ± 0.57 LogMAR (Snellen 20/93), improving postoperatively to 0.17 ± 0.18 (Snellen 20/29) at 1 month (P < 0.0001), and to 0.13 ± 0.14 (Snellen 20/26) by the final follow-up visit (P < 0.0001). Postoperative complications included corneal epithelial defects (8 %), filamentary keratitis (6 %), worsening of corneal epitheliopathy (16 %), posterior capsular opacification (18 %), and cystoid macular edema (4 %). A corrected distance visual acuity of 20/30 or better was achieved in 87 % of the eyes; suboptimal CDVA improvement was attributable to severe ocular surface disease, pre-existing advanced glaucoma, and prior macular surgery.
Phacoemulsification in patients with chronic ocular GVHD is a safe and efficacious procedure resulting in significant visual improvement. Overall, postoperative adverse events responded well to timely management.
KeywordsGraft-versus-host disease Cataract Phacoemulsification Ocular surface disease
The authors thank Dr. Susanne Eiglmeier for her assistance in the preparation of this manuscript.
This work was supported by the National Eye Institute, National Institutes of Health (Grant no: K24-EY019098), and Research to Prevent Blindness.
Conflict of interest
RD is a consultant to Alcon, Allergan, Eleven Biotherapeutics, GlaxoSmithKline, and Rigel. He also holds equity in Eleven Biotherapeutics. No other author has a financial or proprietary interest in any material or method mentioned in this manuscript.
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