June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Cataract Prevalence and Cataract Surgery Outcomes in Patients with Ocular Graft-Versus-Host Disease (GVHD)
Author Affiliations & Notes
  • Ujwala Saboo
    Massachusetts Eye and Ear Infirmary, Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA
  • Hasanain Shikari
    Massachusetts Eye and Ear Infirmary, Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA
  • Reza Dana
    Massachusetts Eye and Ear Infirmary, Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA
  • Footnotes
    Commercial Relationships Ujwala Saboo, None; Hasanain Shikari, None; Reza Dana, Allergan (C), Alcon (C), Bausch & Lomb (C), Eleven Bio (I), GSK (F), Novabay (C), Revision Optics (C), Novaliq (C), RIgel (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3001. doi:
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      Ujwala Saboo, Hasanain Shikari, Reza Dana; Cataract Prevalence and Cataract Surgery Outcomes in Patients with Ocular Graft-Versus-Host Disease (GVHD). Invest. Ophthalmol. Vis. Sci. 2013;54(15):3001.

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

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Abstract

Purpose: To study the prevalence of cataracts and the outcomes of cataract surgery in patients with ocular GVHD after bone marrow/hematopoietic stem cell transplantation.

Methods: Retrospective chart review of 140 patients with ocular GVHD from January 2007- September 2011 was performed.

Results: During the observational period, the overall prevalence of bilateral cataract was 43% (60/140) and unilateral cataract was 3.5% (5/140), while the prevalence of vision impairing cataract requiring surgery was 24% (30/125 eyes with cataract). Eight patients had bilateral pseudophakia at presentation. The mean age at diagnosis of cataract was 53 ±12.5 years (mean ± SD). The index diagnosis of cataract was made at 37±4 months (mean ± SEM) after transplantation. There was an increased risk of cataracts in patients receiving systemic corticosteroids for a duration ≥ 12 months as compared to those receiving corticosteroids <12 months (p=0.022). No significant association was found between cataracts and pre-conditioning with total body irradiation (p=0.38). Ocular surface disease was managed preoperatively with lubricants (100%), punctal occlusion (66%), topical interleukin-1 receptor antagonist (56%), and topical cyclosporine (16%). Stable ocular surface was ensured prior to cataract surgery in all patients. Mean best corrected visual acuity (BCVA) was 20/60 preoperatively and showed significant improvement to 20/30 postoperatively (p=0.0001). Mean follow up after surgery was 17±14 months.

Conclusions: Patients with GVHD have a high prevalence of cataracts. Systemic corticosteroid use for ≥ 12 months significantly increases the risk of cataract formation. Visual outcomes after cataract surgery are generally quite good; however, increased early postoperative surface-related complications need early detection.

Keywords: 486 cornea: tears/tear film/dry eye • 743 treatment outcomes of cataract surgery • 445 cataract  
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