[Ocular complications of long-term survival of bone marrow transplantation. A prospective study with 21 patients]

Survival time after bone marrow transplantation is getting increasingly longer and secondary ocular complications need to be identified and deserve more attention as so far.

We evaluated the ocular complications of 21 not selected, long-term survivors after bone marrow transplantation in a prospective study. The ophthalmological examination consisted of visual acuity, slit lamp examination, tonometry and ophthalmoscopy. It included also determination of tears break-up-time, Jones-test, rose bengal staining and impression cytology of the conjunctiva.

The major ocular complication was the development of a keratoconjunctivitis sicca syndrome in 14 of the 21 patients. This complication is probably due to the total-body irradiation in the preparative before and to the development of a chronic Graft-versus-Host-Disease after transplantation. 13 of the 21 patients developed a cataract. This might be a result of the total-body irradiation and a prolonged high steroid intake.

The frequency and severity of ocular complications suggest that detailed ocular examinations should be performed routinely in patients after bone marrow transplantation.