[Cataract surgery after bone marrow transplantation. Apropos of 36 cases]

Bone marrow transplantation has improved the prognosis of haematological malignancies, but patients are consequently at considerable risk of developing ocular complications, such as cataracts.

A retrospective case study of 36 eyes (24 patients), with cataract extraction after the transplantation. Surgery was performed at a mean of 4.5 years after transplantation and the average age was 33 years at the time of surgery. The lens changes were all of the posterior subcapsular type. Surgery was indicated for symptoms of dazzling and glare; visual acuity was only moderately decreased (4/10, P6).

Cataract surgery required specific measures such to "polish" the posterior lens capsule, since cataract changes were often very adherent. The surgery follow-up was uncomplicated with the exception of five eyes which had an inflammatory reaction (3 cyclitic membrans, 2 "pseudo-endophthalmitis") but which showed complete regression after treatement. The follow-up after surgery varied from 6 months to 4.5 years. Final visual outcome was improved. 82.5% achieved 8/10, and 96.8% achieved P2. Three YAG-laser capsulotomies were performed, mainly for posterior capsulofibrosis.

Cataract surgery after bone marrow transplantation appears to have a good prognosis. Posterior capsule "polishing", though difficult, is possible in most cases. In our study, secondary cataract appears to be less frequent, but, further long-term follow-up is needed to confirm this statement.