Preoperative Management and Cataract Surgery Outcomes in oGVHD

To describe common preoperative treatments and visual outcomes after cataract surgery in patients with definite ocular graft-versus-host disease (oGVHD), as defined by the International Chronic Ocular Graft-Versus-Host-Disease (ICCGVHD) consensus group criteria.

Retrospective study.

Fifty eyes of 33 patients who had definite oGVHD, as defined by the ICCGVHD criteria, and underwent cataract extraction at Mayo Clinic were included.

Various preoperative interventions and best-corrected visual acuity (BCVA) preoperatively, 1 month postoperatively, and at final ophthalmology follow-up were recorded. Postoperative corneal complications were also identified.

Fifty eyes across 33 patients (42% female) were included, with a mean age at cataract surgery of 57 ± 9 years. Common preoperative treatments used for patients included punctal occlusion via plugs or cautery (44 eyes, 88%), artificial tears (35 eyes, 70%), autologous serum tears (22 eyes, 44%); topical nonsteroidal anti-inflammatory drugs were used postoperatively in 7 eyes (14%). BCVA significantly improved from a preoperative mean of Snellen 20/61 (0.487 ± 0.429) to 20/26 at 1 month postoperatively (0.109 ± 0.184, P < 0.001) and remained stable at 20/29 at final ophthalmology follow-up (0.163 ± 0.381, P < 0.001). Postoperative corneal complications developed in 2 eyes (4%), including 1 corneal ulcer and 1 corneal abrasion, both of which resolved within 1 month with appropriate treatment.

The ICCGVHD criteria demonstrate potential for comprehensively evaluating oGVHD before cataract surgery. In addition, patients with definite oGVHD according to these criteria are treated with a variety of interventions preoperatively and are able to achieve favorable postoperative visual outcomes with a low incidence of postoperative corneal complications.