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Huy D Nguyen, Kimberly G Yen; Outcome of cataract surgery in patients treated for retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2432.
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© ARVO (1962-2015); The Authors (2016-present)
Cataract development in patients with retinopathy of prematurity (ROP) can be challenging to manage. We present a retrospective chart review to report the outcome of cataract surgery in patients who had ROP treatment.
Retrospective chart review.
20 eyes (17 patients) with history of ROP treatment and cataracts were included. 19/20 eyes received laser treatment for ROP; 1 eye received intravitreal Avastin. Mean birth age was 25.1 ± 2.2 weeks; mean birthweight was 786 ± 268 grams. Average follow up was 9.9 ± 5.3 years. 15/20 of the eyes received laser only and developed cataracts an average of 4.5 ± 4.7 years after laser treatment. 5/20 (25%) eyes developed cataracts an average of 3.5 ± 3.6 years after lens-sparing pars-plana vitrectomy (LSPPV) in addition to laser. In the Avastin eye, the cataract was noted soon after injection but became visually significant 1.3 years after the injection. In the patients with unilateral cataract and bilaterally treated ROP, the eye with the cataract did not receive a significantly different number of laser spots (p = 0.81) or power (p = 0.44) compared to the contralateral unaffected eye. 18 eyes (78%) underwent cataract extraction with posterior chamber intraocular lens implantation; 9/18 of these eyes received a primary posterior capsulotomy and anterior vitrectomy (PC-ant vx). 2 eyes (10%) were left aphakic. 9/9 of eyes (100%) which did not receive primary PC-ant vx developed visually significant posterior capsular opacification an average of 9.1±8.3 months after cataract surgery; 2/8 eyes who had received PC-ant vx at time of surgery developed visually significant visual axis opacification (VAO) an average of 1.22 ±1.27 years after surgery. There were no intraoperative complications. No patients developed subsequent retinal detachments. Most recent best corrected vision (BCVA) significantly improved from preoperative BCVA (from LogMar 1.2 to 0.7; p = 0.03).
Cataract surgery is associated with a high incidence of visually significant VAO. Development of cataract in patients who have had laser treatment for ROP does not appear to be associated with the laser energy parameters. Needle injury to the posterior capsule during Avastin injection can lead to cataract development, but progression of the cataract can be slow. Visual acuity in patients with treated ROP improves with cataract surgery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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