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Phacoemulsification in patients after allogeneic bone marrow transplantation
1Massachusetts Eye and Ear Associates, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Ophthalmology
|September 6, 2001
Summary
Phacoemulsification effectively restores vision in allogeneic bone marrow transplant (BMT) recipients with cataracts. Aggressive pre- and post-operative management of coexisting ocular diseases, like graft-versus-host disease (GVHD), is crucial for optimal visual outcomes.
Area of Science:
- Ophthalmology
- Hematology
- Transplantation Medicine
Background:
- Cataract formation is a potential complication following allogeneic bone marrow transplant (BMT).
- Graft-versus-host disease (GVHD) frequently affects ocular structures, including the lacrimal glands and conjunctiva, leading to ocular surface disease in BMT recipients.
Purpose of the Study:
- To evaluate the outcomes of phacoemulsification surgery for visually significant cataracts in patients who have undergone allogeneic bone marrow transplant (BMT).
- To assess the impact of pre-existing ocular conditions, particularly GVHD, on surgical results and identify factors influencing visual recovery.
Main Methods:
- Retrospective, noncomparative, interventional case series of 34 eyes from 19 BMT recipients with cataracts.
- Data collected included best-corrected visual acuity, postoperative complications, and management of ocular surface disease related to GVHD.
- Surgical intervention was performed after successful management of ocular surface disease.
Main Results:
- Phacoemulsification was performed at a mean of 37 months post-BMT, with a mean follow-up of 13 months.
- Ocular surface disease due to GVHD affected 62% of eyes, with 71% of those also having conjunctival GVHD.
- Postoperative visual acuity was 20/30 or better in 97% of eyes; posterior capsular opacification occurred in 44%.
Conclusions:
- Phacoemulsification is a safe and effective procedure for improving vision in BMT patients with cataracts.
- Proactive and aggressive management of ocular surface disease, especially GVHD, is essential before and after cataract surgery to achieve successful visual outcomes.