Cataract extraction in adults with retinopathy of prematurity

To review the results of lensectomies performed to remove visually significant cataracts in adults with regressed retinopathy of prematurity, with special reference to postoperative vision and retinal complications.

A chart review of consecutive cases of cataract extraction in eyes with visually significant lens opacities and regressed retinopathy of prematurity was conducted.

Fourteen consecutive eyes with retinopathy of prematurity in 10 adult patients were identified as having undergone lensectomy to manage a visually significant cataract. These cataract extractions were performed between June 1970 and February 1993. There were eight women and two men aged 16 to 43 years at the time of lensectomy. A variety of lenticular opacities were noted, the most common of which was nuclear sclerosis. Additionally, the nuclei were frequently much harder than would be expected for the patient's age. Phacoemulsification with implantation of a posterior chamber intraocular lens was the most common technique for cataract extraction. Eight eyes experienced improvement in visual acuity. However, when preoperative visual acuity was less than 20/200, postoperative acuity of 20/60 or better was uncommon. Six eyes were being treated for glaucoma before lensectomy. Glaucoma control was facilitated after lensectomy in six eyes. No combined cataract extraction and filtering procedures were performed. One eye developed a rhegmatogenous retinal detachment 76 months after cataract extraction. The retina was successfully reattached, but the eye suffered a substantial decrease in visual acuity.

Cataract extraction in adult patients with retinopathy of prematurity may improve visual acuity, facilitate examination and treatment of the posterior segment, and aid in the management of glaucoma. The risk of retinal complications in these patients does not appear to be excessive.