June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Cataract Extraction Outcomes and the Prevalence of Zonular Insufficiency in Retinitis Pigmentosa
Author Affiliations & Notes
  • Clement Chow
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • Mark Dikopf
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • William Mieler
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • Elmer Tu
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • Footnotes
    Commercial Relationships Clement Chow, None; Mark Dikopf, None; William Mieler, Genentech (C), Alcon (C), Allergan (C); Elmer Tu, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1262. doi:
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    • Get Citation

      Clement Chow, Mark Dikopf, William Mieler, Elmer Tu; Cataract Extraction Outcomes and the Prevalence of Zonular Insufficiency in Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1262.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To report surgical outcomes and the prevalence of zonular insufficiency in patients with retinitis pigmentosa (RP) undergoing phacoemulsification cataract extraction.

Methods: Single institution retrospective study of consecutive RP patients who underwent phacoemulsification cataract extraction and intraocular lens implantation by a single surgeon between 2002 and 2012. Preoperative, intraoperative, and postoperative records were analyzed with attention to best-corrected visual acuity (BCVA), lens and zonular status, capsular tension ring use, incidence of posterior capsular opacification and neodymium-doped yttrium aluminum garnet (YAG) laser capsulotomy, and surgical complications.

Results: Eighty eyes of 47 RP patients (21 male) underwent cataract surgery during the study period at an average age of 48.9 years (range 31-78 years). Mean follow up time was 23.3 months (range = 1 day - 95 months). Posterior subcapsular cataracts were present in 97.5% of patients. Mean BCVA improved from 20/340 (logarithm of the Minimum Angle of Resolution [logMAR] 1.23) to 20/129 (0.81) within three months of surgery, P < 0.0001. When focusing on eyes with a preoperative vision of 20/40 to 20/200 (47 eyes), visual acuities improved from a mean of 20/81 (logMAR 0.61) to 20/43 (0.33), P < 0.0001. Posterior capsule opacification occurred in 66 eyes (82.5%), and 42 eyes (52.5%) underwent a YAG laser capsulotomy at a mean of 10.8 months after surgery. Fifteen eyes (18.8%) of 10 patients (21.3%) had signs of phacodonesis (3 eyes noted preoperatively, 8 intraoperatively and 4 post-operatively). One patient had bilateral dislocated in-the bag intraocular lenses at 5.5 years and 6 years after surgery.

Conclusions: Cataract surgery yields significantly improved visual acuity in a majority of RP patients with a preoperative vision of 20/200 or better. Conversely, patients with a preoperative visual acuity of 20/400 or worse have more limited objective improvements likely because of macular involvement, but may still have considerable subjective improvements. A high incidence of zonular instability is seen in the RP population. It is important to conduct a careful preoperative assessment of lens stability with preparation for adjunctive methods that augment intraoperative and postoperative lens stabilization.

Keywords: 445 cataract • 696 retinal degenerations: hereditary • 743 treatment outcomes of cataract surgery  
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